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Tyson Rae Flora, MALMHC
Mental Health Counselor in Fort Wayne, Indiana
NPI 1083709554

Tyson Rae Flora is a Mental Health Counselor based in Fort Wayne, IN and is specialized in Mental Health. Tyson Rae Flora practices in Fort Wayne, IN and has the professional credentials of MALMHC. The NPI Number for Tyson Rae Flora is 1083709554 and holds a License No. 39001576A (Indiana).

The current practice location address for Tyson Rae Flora is 6202 Constitution Dr Ste D, Fort Wayne, IN and can be reached out via phone at 260-432-0066 and via fax at 260-432-8503.

Location: 6202 Constitution Dr Ste D, Fort Wayne, IN, 46804-1583
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Provider Profile Details
NPI Number
1083709554
Provider Name
Tyson Rae Flora
Credential
MALMHC
Provider Entity Type
Individual
Gender
Female
Address
6202 Constitution Dr Ste D, Fort Wayne, IN, 46804-1583
Phone Number
260-432-0066
Fax Number
260-432-8503
Provider Enumeration Date
10/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200912670A 05 IN
39001576A 01 IN LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
6202 Constitution Dr Ste D
City
State
Zip
46804-1583
Phone Number
260-432-0066
Fax Number
260-432-8503
person
Provider Business Mailing Address Details
Address
6202 Constitution Dr Ste D
City
State
Zip
46804-1583
Phone Number
260-432-0066
Fax Number
260-432-8503
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
39001576A (Indiana)
Definition
Definition to come...
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