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General NPI Number Information
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NPI Number | 1679469456
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Entity Type | Individual
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Provider Name | MAHALA FLEMING
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Gender | Female
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 609 3RD AVE
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City | CHESAPEAKE
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State | OH
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Zip | 45619-1038
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Country | US
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Telephone | 740-858-7825
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 LAWRENCE ST APT B7
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City | IRONTON
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State | OH
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Zip | 45638-9043
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Country | US
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Telephone | 740-858-7825
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.192782
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License Number State | OH
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