Provider Demographics
NPI:1053626143
Name:FLEMING, TAMMY SUE (COTA/L)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:SUE
Last Name:FLEMING
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 ROLLING HILL WALK APT 302
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-2415
Mailing Address - Country:US
Mailing Address - Phone:443-834-4576
Mailing Address - Fax:
Practice Address - Street 1:602 ROLLING HILL WALK APT 302
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-2415
Practice Address - Country:US
Practice Address - Phone:443-834-4576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00470224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant