Provider Demographics
NPI:1780030759
Name:FLEMING, CORINNE RAE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CORINNE
Middle Name:RAE
Last Name:FLEMING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:RAE
Other - Last Name:BRENNEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2948 ARTESIAN RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8558
Mailing Address - Country:US
Mailing Address - Phone:630-428-7890
Mailing Address - Fax:630-428-7891
Practice Address - Street 1:2948 ARTESIAN RD
Practice Address - Street 2:SUITE 112
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8558
Practice Address - Country:US
Practice Address - Phone:630-428-7890
Practice Address - Fax:630-428-7891
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009292103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical