Provider Demographics
NPI:1467176909
Name:FLANIGAN, AUBREY
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:FLANIGAN
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 1:20134 VALLEY FORGE CIR
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1112
Mailing Address - Country:US
Mailing Address - Phone:610-878-9330
Mailing Address - Fax:267-552-1002
Practice Address - Street 1:20134 VALLEY FORGE CIR
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1112
Practice Address - Country:US
Practice Address - Phone:610-878-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019719103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty