Provider Demographics
NPI:1710505722
Name:FLYNN, CHRISTOPHER II
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:FLYNN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 W HORIZON RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-5202
Mailing Address - Country:US
Mailing Address - Phone:323-202-9382
Mailing Address - Fax:
Practice Address - Street 1:540 W HORIZON RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-5202
Practice Address - Country:US
Practice Address - Phone:323-202-9382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health