Provider Demographics
NPI:1801208533
Name:DINSMORE, VICKIE (MED)
Entity Type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:
Last Name:DINSMORE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6192 SILVER WOOD DR
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-7931
Mailing Address - Country:US
Mailing Address - Phone:513-899-5275
Mailing Address - Fax:
Practice Address - Street 1:605 WELCH ROAD
Practice Address - Street 2:LITTLE MIAMI LOCAL SCHOOLS - SALEM ELEMENTARY
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152
Practice Address - Country:US
Practice Address - Phone:513-899-5275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP . 6593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist