Provider Demographics
NPI:1043860349
Name:FLORES, AMBER (MFT)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8917 N DAVIS HWY APT 165
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-5333
Mailing Address - Country:US
Mailing Address - Phone:210-471-8243
Mailing Address - Fax:
Practice Address - Street 1:9511 HOLSBERRY RD STE B7
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-1320
Practice Address - Country:US
Practice Address - Phone:850-972-9015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT2506106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist