Provider Demographics
NPI:1073244588
Name:FLEIG, TAYLOR LEIGH
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LEIGH
Last Name:FLEIG
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:PO BOX 543
Mailing Address - Street 2:
Mailing Address - City:HAMEL
Mailing Address - State:IL
Mailing Address - Zip Code:62046-0543
Mailing Address - Country:US
Mailing Address - Phone:636-251-0023
Mailing Address - Fax:
Practice Address - Street 1:10075 LEWIS AND CLARK BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-5503
Practice Address - Country:US
Practice Address - Phone:636-251-0023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker