Provider Demographics
NPI:1699216721
Name:FLORES, ABIGAIL (LPC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S CROWLEY RD
Mailing Address - Street 2:# 504
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-3251
Mailing Address - Country:US
Mailing Address - Phone:817-680-6693
Mailing Address - Fax:
Practice Address - Street 1:200 S CROWLEY RD
Practice Address - Street 2:# 504
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-3251
Practice Address - Country:US
Practice Address - Phone:817-680-6693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71798101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional