Provider Demographics
NPI:1316507445
Name:FLEMING, MCKALE ASHLEY (LMT, IBCLC)
Entity type:Individual
Prefix:
First Name:MCKALE
Middle Name:ASHLEY
Last Name:FLEMING
Suffix:
Gender:F
Credentials:LMT, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:BALL GROUND
Mailing Address - State:GA
Mailing Address - Zip Code:30107-0004
Mailing Address - Country:US
Mailing Address - Phone:229-360-6667
Mailing Address - Fax:470-600-0925
Practice Address - Street 1:PO BOX 4
Practice Address - Street 2:
Practice Address - City:BALL GROUND
Practice Address - State:GA
Practice Address - Zip Code:30107-0004
Practice Address - Country:US
Practice Address - Phone:229-360-6676
Practice Address - Fax:470-600-0925
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAL-302590174N00000X
171400000X, 174N00000X
GAMT006471225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No171400000XOther Service ProvidersHealth & Wellness Coach
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist