Provider Demographics
NPI:1841363090
Name:FLEMING, ANGELITA LEE (MS)
Entity type:Individual
Prefix:MS
First Name:ANGELITA
Middle Name:LEE
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 1:1395 PALACE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2555
Mailing Address - Country:US
Mailing Address - Phone:651-698-0955
Mailing Address - Fax:
Practice Address - Street 1:5842 BLACKSHIRE PATH STE 201
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-1619
Practice Address - Country:US
Practice Address - Phone:651-544-9940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7974235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist