Provider Demographics
NPI:1629279427
Name:FLORES-O'TOOLE, GINA MAUREEN (EDS, MFT, LCADC-S)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:MAUREEN
Last Name:FLORES-O'TOOLE
Suffix:
Gender:F
Credentials:EDS, MFT, LCADC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-5675
Mailing Address - Country:US
Mailing Address - Phone:775-322-8941
Mailing Address - Fax:
Practice Address - Street 1:900 W 1ST ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5675
Practice Address - Country:US
Practice Address - Phone:775-322-8941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101YP2500X
NVMI0168106H00000X
NV1260101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist