Provider Demographics
NPI:1043403652
Name:WILLIAMS, JAIMIE LYNN (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:JAIMIE
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1465 DRIFTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-1423
Mailing Address - Country:US
Mailing Address - Phone:330-468-7783
Mailing Address - Fax:
Practice Address - Street 1:101 S BISSELL RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-9170
Practice Address - Country:US
Practice Address - Phone:330-562-5000
Practice Address - Fax:330-562-5181
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 7958235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist