Basic Information
| Provider Information | |||||||||
| NPI: | 1134486293 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLOWERS | ||||||||
| FirstName: | JADE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 349 E COOKE RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432142801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142842808 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7400 HUNTINGTON PARK DR | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145050378 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2012 | ||||||||
| LastUpdateDate: | 06/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | M1300023 | OH | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.