Basic Information
| Provider Information | |||||||||
| NPI: | 1578214532 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLORES HERNANDEZ | ||||||||
| FirstName: | KARLA MARIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6322 STEEPLE CHASE CT | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660495045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5168717963 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2619 W 6TH ST STE C | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660494300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858308299 | ||||||||
| FaxNumber: | 7857492581 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2022 | ||||||||
| LastUpdateDate: | 01/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | LMLP03103-T | KS | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.