Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | NY | |
Y | 101YS0200X | School Counselor | NY |
NPI | 1003576497 |
---|---|
Provider Name | Gabriel Flores |
First Address | Rego Park, NY 11374-5018 |
Second Address | New York, NY 10024-4018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2021 |
Last Update Date | 27/12/2021 |