Provider Demographics
NPI:1336770775
Name:FLEMING, ELIZABETH STEIN
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:STEIN
Last Name:FLEMING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:BILLKESE
Other - Last Name:STEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1303 MARSHALLTON THORNDALE RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3736
Mailing Address - Country:US
Mailing Address - Phone:717-799-5507
Mailing Address - Fax:
Practice Address - Street 1:1303 MARSHALLTON THORNDALE RD
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3736
Practice Address - Country:US
Practice Address - Phone:717-799-5507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015599225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty