Provider Demographics
NPI:1437663192
Name:FLORES, MICHELLE PATRICIA (PHD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:PATRICIA
Last Name:FLORES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8670 W CHEYENNE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7456
Mailing Address - Country:US
Mailing Address - Phone:702-253-4206
Mailing Address - Fax:702-583-7010
Practice Address - Street 1:8670 W CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7456
Practice Address - Country:US
Practice Address - Phone:702-253-4206
Practice Address - Fax:702-583-7010
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0884103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist