Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1013244433 |
---|---|
Provider Name | Dr. Michele A Fleming |
First Address | Jacksonville, FL 32223-0798 |
Second Address | Jacksonville, FL 32223-0798 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2009 |
Last Update Date | 05/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VA74352 | NATIONAL CHRISTIAN COUNSELORS ASSOCIATION (01) | FL |