Provider Demographics
NPI:1013365907
Name:FLOWERS, ANTWONE
Entity Type:Individual
Prefix:
First Name:ANTWONE
Middle Name:
Last Name:FLOWERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 N HUALAPAI WAY
Mailing Address - Street 2:#2023
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-4062
Mailing Address - Country:US
Mailing Address - Phone:818-220-3337
Mailing Address - Fax:
Practice Address - Street 1:3540 N HUALAPAI WAY
Practice Address - Street 2:#2023
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-4062
Practice Address - Country:US
Practice Address - Phone:818-220-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health