Provider Demographics
NPI:1558445270
Name:RICHMOND, JAIME E (MA CCCSLP)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:E
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:MA CCCSLP
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:E
Other - Last Name:VALDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1295 THOREAU RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107
Mailing Address - Country:US
Mailing Address - Phone:216-280-6291
Mailing Address - Fax:
Practice Address - Street 1:14587 MADISON AVENUE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4395
Practice Address - Country:US
Practice Address - Phone:216-521-5050
Practice Address - Fax:216-521-8797
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7926235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist