Basic Information
Provider Information
NPI: 1679725329
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLORA
FirstName: SHARLA
MiddleName:  
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Credential:  
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Mailing Information
Address1: 3125 POPLARWOOD CT STE 203
Address2:  
City: RALEIGH
State: NC
PostalCode: 276046445
CountryCode: US
TelephoneNumber: 9197876131
FaxNumber:  
Practice Location
Address1: 301 SUNSET DR
Address2:  
City: FUQUAY VARINA
State: NC
PostalCode: 275262196
CountryCode: US
TelephoneNumber: 9197876131
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/14/2008
LastUpdateDate: 10/14/2008
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X1287NCY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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