Provider Demographics
NPI:1093491722
Name:FLEMING, KELLVER VEVICIA
Entity type:Individual
Prefix:
First Name:KELLVER
Middle Name:VEVICIA
Last Name:FLEMING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5029 FILLMORE AVE 204
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311
Mailing Address - Country:US
Mailing Address - Phone:702-344-4500
Mailing Address - Fax:
Practice Address - Street 1:110 HERNDON PKWY SUIT 205
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170
Practice Address - Country:US
Practice Address - Phone:571-305-1906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant