Provider Demographics
NPI:1891186052
Name:FLEMING, RAQUEL (MS)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 SE POMEROY ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-3901
Mailing Address - Country:US
Mailing Address - Phone:772-285-9234
Mailing Address - Fax:
Practice Address - Street 1:169 TEQUESTA DR
Practice Address - Street 2:SUITE 24E
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-2768
Practice Address - Country:US
Practice Address - Phone:561-747-8188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ6997235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist