Provider Demographics
NPI:1881759017
Name:FLEMING, DEODIS DEWITT (CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:DEODIS
Middle Name:DEWITT
Last Name:FLEMING
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LAMONT DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-2117
Mailing Address - Country:US
Mailing Address - Phone:501-569-9991
Mailing Address - Fax:501-562-9405
Practice Address - Street 1:10 LAMONT DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-2117
Practice Address - Country:US
Practice Address - Phone:501-569-9991
Practice Address - Fax:501-562-9405
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR255235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist