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Individual
MS. MARY ELLEN FLEMING
Active
Individual
MS. MARY ELLEN FLEMING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,MA LPC QMHP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.008617
IL
163W00000X
Registered Nurse
041.229014
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362480845
—
IL
Enumeration date
05/15/2013
Last updated
05/15/2013
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