Provider Demographics
NPI:1285781781
Name:FLEMING, AMY ALEXANDER (AUD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:ALEXANDER
Last Name:FLEMING
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:FRANCES
Other - Last Name:FLEETWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:5204 COUNTY ROAD 204
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-7328
Mailing Address - Country:US
Mailing Address - Phone:573-544-7402
Mailing Address - Fax:573-642-4686
Practice Address - Street 1:850 W. HOSPITAL DR.
Practice Address - Street 2:SUITE G
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251
Practice Address - Country:US
Practice Address - Phone:573-544-7402
Practice Address - Fax:573-642-4686
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001031974231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO336263306Medicaid