Individual
OMAR FLORES TAVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
110 KELLWOOD DR STE B, PERRY, GA 31069-3263
(229) 200-6524
Mailing address
106 MICHELE TER, WARNER ROBINS, GA 31088-3924
(229) 200-6524
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MFT000887
GA
106H00000X
Marriage & Family Therapist
Primary
000887
GA
Other
Enumeration date
01/30/2007
Last updated
12/30/2020
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