Provider Demographics
NPI:1558897652
Name:FLUITT, TAMMY
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:
Last Name:FLUITT
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 1:225 LARK ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613-1621
Mailing Address - Country:US
Mailing Address - Phone:585-355-0440
Mailing Address - Fax:
Practice Address - Street 1:232 PLYMOUTH AVE S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-2237
Practice Address - Country:US
Practice Address - Phone:585-232-1990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor