Provider Demographics
NPI:1720556897
Name:MCLEMORE, AIMEE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:
Last Name:MCLEMORE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1949 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45403-1909
Mailing Address - Country:US
Mailing Address - Phone:419-233-1784
Mailing Address - Fax:
Practice Address - Street 1:597 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-9510
Practice Address - Country:US
Practice Address - Phone:937-456-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-12852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSP-12852OtherOHIO BOARD OF SPEECH LANGUAGE PATHOLOGIST