Provider Demographics
NPI:1407408941
Name:FLORES, MONIQUE (RBT-19-92574)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:RBT-19-92574
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7714 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-3334
Mailing Address - Country:US
Mailing Address - Phone:409-599-4645
Mailing Address - Fax:
Practice Address - Street 1:7714 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-3334
Practice Address - Country:US
Practice Address - Phone:409-599-4645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-19-92574106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician