Individual
CAROLYN FLORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 PREMIERE PKWY, DULUTH, GA 30097-5014
(866) 523-4268
Mailing address
DEPT LA 22763, PASADENA, CA 91185-0001
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061109892
INDIVIDUAL TYPE 1 NPI
GA
Enumeration date
07/18/2022
Last updated
07/20/2022
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