Provider Demographics
NPI:1164768362
Name:FLORES, WENDY ANN (LMHCA)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:ANN
Last Name:FLORES
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18019 PALATINE AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4333
Mailing Address - Country:US
Mailing Address - Phone:206-466-8336
Mailing Address - Fax:
Practice Address - Street 1:18019 PALATINE AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4333
Practice Address - Country:US
Practice Address - Phone:206-466-8336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60154145101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health