Provider Demographics
NPI:1316537657
Name:FLEMMING, SOMMER
Entity Type:Individual
Prefix:
First Name:SOMMER
Middle Name:
Last Name:FLEMMING
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 1:1835 COUNTY ROAD C W STE 41
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1343
Mailing Address - Country:US
Mailing Address - Phone:651-638-0080
Mailing Address - Fax:702-564-4838
Practice Address - Street 1:1835 COUNTY ROAD C W STE 41
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1343
Practice Address - Country:US
Practice Address - Phone:651-638-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105897225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist