Provider Demographics
NPI:1942955000
Name:FLEMING, KRISTINE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6513 E CLIFTON TER
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-9283
Mailing Address - Country:US
Mailing Address - Phone:602-815-0065
Mailing Address - Fax:
Practice Address - Street 1:6411 N ROBERT RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-9146
Practice Address - Country:US
Practice Address - Phone:602-815-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-007998225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist