Provider Demographics
NPI:1083393565
Name:SOTO CONTRERAS, FLOR
Entity Type:Individual
Prefix:
First Name:FLOR
Middle Name:
Last Name:SOTO CONTRERAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7617 NW 94TH CT
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-3082
Mailing Address - Country:US
Mailing Address - Phone:515-205-4420
Mailing Address - Fax:
Practice Address - Street 1:5550 WILD ROSE LN STE 400
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5351
Practice Address - Country:US
Practice Address - Phone:515-650-1867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA120519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health