Provider Demographics
NPI:1649457862
Name:FERNANDEZ, FLOR TERESA (LMFT)
Entity type:Individual
Prefix:DR
First Name:FLOR
Middle Name:TERESA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 WESTLAKE AVE N STE 120
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2707
Mailing Address - Country:US
Mailing Address - Phone:206-284-0912
Mailing Address - Fax:
Practice Address - Street 1:1818 WESTLAKE AVE N STE 120
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2707
Practice Address - Country:US
Practice Address - Phone:206-284-0912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001676106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist