Provider Demographics
NPI:1568029924
Name:FLORA, ZACHARY CRAIG (LADC/MH)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:CRAIG
Last Name:FLORA
Suffix:
Gender:M
Credentials:LADC/MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10707 BROADWAY EXT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-6212
Mailing Address - Country:US
Mailing Address - Phone:405-946-7337
Mailing Address - Fax:405-242-4487
Practice Address - Street 1:10707 BROADWAY EXT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-6212
Practice Address - Country:US
Practice Address - Phone:405-946-7337
Practice Address - Fax:405-242-4487
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1359101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty