Provider Demographics
NPI:1326699489
Name:FLEMING, HEIDI SIMMONS (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:SIMMONS
Last Name:FLEMING
Suffix:
Gender:F
Credentials: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:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:ELDERTON
Mailing Address - State:PA
Mailing Address - Zip Code:15736-0146
Mailing Address - Country:US
Mailing Address - Phone:724-388-3083
Mailing Address - Fax:
Practice Address - Street 1:309 E SALTWORK ST.
Practice Address - Street 2:
Practice Address - City:ELDERTON
Practice Address - State:PA
Practice Address - Zip Code:15736
Practice Address - Country:US
Practice Address - Phone:844-536-8266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09241235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist