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General NPI Number Information
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NPI Number | 1043074628
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Entity Type | Individual
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Provider Name | HOLLY FLEMING
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Gender | Female
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 803 SE PLAZA AVE STE 1
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City | BENTONVILLE
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State | AR
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Zip | 72712-7830
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Country | US
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Telephone | 479-362-5724
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 W STONEY BROOK RD APT 15202
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City | ROGERS
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State | AR
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Zip | 72758-4672
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Country | US
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Telephone | 479-530-0744
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9853-C
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License Number State | AR
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