Provider Demographics
NPI:1609015932
Name:FLORES, BLANCHE (MS)
Entity Type:Individual
Prefix:MRS
First Name:BLANCHE
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 LOST CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2914
Mailing Address - Country:US
Mailing Address - Phone:361-992-6719
Mailing Address - Fax:361-992-5719
Practice Address - Street 1:6105 LOST CREEK DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2914
Practice Address - Country:US
Practice Address - Phone:361-992-6719
Practice Address - Fax:361-992-5719
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13630101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional