Provider Demographics
NPI:1881827509
Name:FLORES, DIANNA POWELL (MA, LPC-I)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:POWELL
Last Name:FLORES
Suffix:
Gender:F
Credentials:MA, LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 RANCHO VERDE PKWY
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-9440
Mailing Address - Country:US
Mailing Address - Phone:817-919-4001
Mailing Address - Fax:
Practice Address - Street 1:5012 RANCHO VERDE PKWY
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-9440
Practice Address - Country:US
Practice Address - Phone:817-919-4001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65243101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional