Provider Demographics
NPI:1508099623
Name:FLEMMING, VALERIE KAY (M A CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:VALERIE
Middle Name:KAY
Last Name:FLEMMING
Suffix:
Gender:F
Credentials:M A CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 CREEKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-0144
Mailing Address - Country:US
Mailing Address - Phone:706-738-5968
Mailing Address - Fax:706-738-5968
Practice Address - Street 1:2009 CREEKSIDE CT
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-0144
Practice Address - Country:US
Practice Address - Phone:706-738-5968
Practice Address - Fax:706-738-5968
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4402235Z00000X
GASLP007491235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA1064Medicaid