Basic Information
Provider Information
NPI: 1376912709
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLEMING
FirstName: BRITTANY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BARSIC
OtherFirstName: BRITTANY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 7985 GREENRIDGE CT
Address2:  
City: MENTOR
State: OH
PostalCode: 440605932
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4255 NORTHFIELD RD
Address2:  
City: HIGHLAND HILLS
State: OH
PostalCode: 441282811
CountryCode: US
TelephoneNumber: 2162929700
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/16/2015
LastUpdateDate: 01/31/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XCOND-2016006-SPOHY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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