Provider Demographics
NPI:1689986010
Name:FLOWERS, ANGELA CRYSTAL
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:CRYSTAL
Last Name:FLOWERS
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 1:24451 LAKE SHORE BLVD APT 1121
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1257
Mailing Address - Country:US
Mailing Address - Phone:216-394-3012
Mailing Address - Fax:
Practice Address - Street 1:2201 W 93RD ST APT 250
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-3781
Practice Address - Country:US
Practice Address - Phone:216-659-8109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0500270104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker