Provider Demographics
NPI:1831667575
Name:FLEISHMAN, KELLY I
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:I
Last Name:FLEISHMAN
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 1:8 SUPREME CT
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2817
Mailing Address - Country:US
Mailing Address - Phone:908-752-7256
Mailing Address - Fax:
Practice Address - Street 1:1390 PICCARD DR STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4368
Practice Address - Country:US
Practice Address - Phone:301-327-5199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst