Provider Demographics
NPI:1043761828
Name:FLEMING, KRISTIN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 HOLLY HILL LN
Mailing Address - Street 2:STE A
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5691
Mailing Address - Country:US
Mailing Address - Phone:336-350-9263
Mailing Address - Fax:336-350-9264
Practice Address - Street 1:350 HOLLY HILL LN
Practice Address - Street 2:STE A
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5691
Practice Address - Country:US
Practice Address - Phone:336-350-9263
Practice Address - Fax:336-350-9264
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9858235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist