Provider Demographics
NPI:1942913793
Name:FLORES, VERONICA D (CPSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:D
Last Name:FLORES
Suffix:
Gender:F
Credentials:CPSW
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:D
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPSW
Mailing Address - Street 1:4210 MEADOWLARK LN SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1021
Mailing Address - Country:US
Mailing Address - Phone:505-737-2521
Mailing Address - Fax:505-998-7328
Practice Address - Street 1:4210 MEADOWLARK LN SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1021
Practice Address - Country:US
Practice Address - Phone:505-737-2521
Practice Address - Fax:505-998-7328
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1494101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)