Healthcare Provider Details

I. General information

NPI: 1801733498
Provider Name (Legal Business Name): AYLA GRACE FLECK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AYLA GRACE LEMKE

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E 2ND ST
DULUTH MN
55805-1913
US

IV. Provider business mailing address

400 E 3RD ST
DULUTH MN
55805-1951
US

V. Phone/Fax

Practice location:
  • Phone: 218-727-8762
  • Fax:
Mailing address:
  • Phone: 218-786-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number108068
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: