Provider Demographics
NPI:1467270330
Name:FLEMISTER, JAMEL TRAVON
Entity type:Individual
Prefix:
First Name:JAMEL
Middle Name:TRAVON
Last Name:FLEMISTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4671 COUNTRY LN APT 315
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5824
Mailing Address - Country:US
Mailing Address - Phone:216-551-2968
Mailing Address - Fax:
Practice Address - Street 1:1051 TIFFANY S
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-1977
Practice Address - Country:US
Practice Address - Phone:330-629-2955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician