Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 178.071588 | IL |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 37027 | IL |
NPI | 1003572173 |
---|---|
Provider Name | Veronica Natalie Flores |
First Address | Rockford, IL 61107-3874 |
Second Address | Chicago, IL 60613-3601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2021 |
Last Update Date | 12/11/2021 |