MEDICARE: MCKALE ASHLEY FLEMING BA, IBCLC, LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach		GA
2	225700000X	Massage Therapist	MT006471	GA
3	174N00000X	Lactation Consultant (Non-RN)	L-302590	GA
4	133N00000X	Nutritionist		GA

General Provider Information

NPI Number	:	1316507445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MCKALE ASHLEY FLEMING BA, IBCLC, LMT

Provider Business Mailing Address
First Line	:	327 DAHLONEGA ST STE B1804
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-8217
Country	:	US
Telephone Number	:	229-360-6676
Fax Number	:	470-600-0925

Provider Business Practice Location Address
First Line	:	327 DAHLONEGA ST STE B1804
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-8217
Country	:	US
Telephone Number	:	229-360-6676
Fax Number	:	470-600-0925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	09/15/2025

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