Provider Demographics
NPI:1972058253
Name:FLETCHER, CAMRIE LYNN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAMRIE
Middle Name:LYNN
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:CAMRIE
Other - Middle Name:LYNN
Other - Last Name:COPIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8246 N CEDAR SPRINGS RD APT 7
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-2627
Mailing Address - Country:US
Mailing Address - Phone:801-661-9007
Mailing Address - Fax:
Practice Address - Street 1:8246 N CEDAR SPRINGS RD APT 7
Practice Address - Street 2:
Practice Address - City:EAGLE MOUNTAIN
Practice Address - State:UT
Practice Address - Zip Code:84005-2627
Practice Address - Country:US
Practice Address - Phone:801-661-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9533113-4102235Z00000X
CASP 24664235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist