Provider Demographics
NPI:1295971232
Name:FLORES, ROSA ELVIRA (MA, CAC III, DAACS)
Entity type:Individual
Prefix:MS
First Name:ROSA
Middle Name:ELVIRA
Last Name:FLORES
Suffix:
Gender:F
Credentials:MA, CAC III, DAACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12101 E 2ND AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8327
Mailing Address - Country:US
Mailing Address - Phone:303-579-1206
Mailing Address - Fax:303-364-3932
Practice Address - Street 1:12101 E 2ND AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8327
Practice Address - Country:US
Practice Address - Phone:303-579-1206
Practice Address - Fax:303-364-3932
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7949101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health