Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | 20042181A | IN |
NPI | 1043405350 |
---|---|
Provider Name | Amber Rae Fleming |
First Address | Indianapolis, IN 46280-2301 |
Second Address | Indianapolis, IN 46280-2301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2007 |
Last Update Date | 19/03/2015 |