Provider Demographics
NPI:1033520432
Name:FLOWERS, JEREMY (MA)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:FLOWERS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 BUNKERHILL ST APT 204
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1165
Mailing Address - Country:US
Mailing Address - Phone:703-785-1756
Mailing Address - Fax:
Practice Address - Street 1:5700 BUNKERHILL ST
Practice Address - Street 2:APT 204
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1162
Practice Address - Country:US
Practice Address - Phone:703-785-1756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-19
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002728103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst