Provider Demographics
NPI:1770846081
Name:FLEMING, HOLLIE M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HOLLIE
Middle Name:M
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 1:1925 VILLAGE CENTER CIR STE 150
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6261
Mailing Address - Country:US
Mailing Address - Phone:417-860-3782
Mailing Address - Fax:
Practice Address - Street 1:1925 VILLAGE CENTER CIR STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6261
Practice Address - Country:US
Practice Address - Phone:178-603-7824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK328235Z00000X
IL146.012043235Z00000X
MO2009004968235Z00000X
NVSP-3189235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist