Provider Demographics
NPI:1225157530
Name:FLEMING, TAMRA (SLP)
Entity Type:Individual
Prefix:
First Name:TAMRA
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PINE CONE DR
Mailing Address - Street 2:SUITE 104B
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8686
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 PINE CONE DR
Practice Address - Street 2:SUITE 104B
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8686
Practice Address - Country:US
Practice Address - Phone:386-446-9716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7389235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist