Provider Demographics
NPI:1114402567
Name:FLOWERS, DIANE
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:FLOWERS
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 1:76 GLEN RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4131
Mailing Address - Country:US
Mailing Address - Phone:802-861-2584
Mailing Address - Fax:802-864-1619
Practice Address - Street 1:76 GLEN RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4131
Practice Address - Country:US
Practice Address - Phone:802-861-2584
Practice Address - Fax:802-864-1619
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor