Basic Information
| Provider Information | |||||||||
| NPI: | 1275738114 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLEMING-FRUM | ||||||||
| FirstName: | KRISTI | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MC, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | RR 1 BOX 584 | ||||||||
| Address2: | 488 GREENBRIER ESTATES | ||||||||
| City: | POINT PLEASANT | ||||||||
| State: | WV | ||||||||
| PostalCode: | 255509746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046756253 | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 PINECREST DR | ||||||||
| Address2: | |||||||||
| City: | GALLIPOLIS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456311347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404467112 | ||||||||
| FaxNumber: | 7404469088 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SP 8195 | OH | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.