Provider Demographics
NPI:1073201000
Name:FLEMING, DANIELE MARIE
Entity Type:Individual
Prefix:
First Name:DANIELE
Middle Name:MARIE
Last Name:FLEMING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 COUNTY LINE AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-2711
Mailing Address - Country:US
Mailing Address - Phone:678-410-6987
Mailing Address - Fax:
Practice Address - Street 1:359 PEEVY ST
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3227
Practice Address - Country:US
Practice Address - Phone:770-271-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013195101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional