Doctor Name: | MR. MICHAEL DOUGLAS FLORA |
NPI Number: | 1124242763 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC, LPCC, LSW |
License Number: | E0001970 |
Business Practice Address: | 12 Health Services Dr Dekalb, IL - 601159637 |
Business Phone Number: | 8157564875 |
Business Fax Number: | 8157562944 |
Mailing Address: | 198 Larking Ave, DEKALB |
State: | IL |
Postal Code: | 601158267 |
Phone Number: | 8157549994 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | E0001970 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |