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Individual
MR. RUDOLPH FLORA
Active
Individual
MR. RUDOLPH FLORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002186
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116049
VALUE OPTIONS
VA
05
—
1295758407
—
VA
01
—
238172
ANTHEM BCBS VA-AB OFFICE
VA
01
—
5095412
AETNA BEH HEALTH-ABING
VA
Enumeration date
07/26/2006
Last updated
03/26/2015
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