Individual
JAMIE MIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N ERIE HWY STE A, HAMILTON, OH 45011-4264
(513) 887-3710
Mailing address
1110 WATERWYCK TRL, DAYTON, OH 45458-9637
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP9473
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
(800) 324-8680
—
OH
05
—
8003248680
—
OH
Enumeration date
08/26/2016
Last updated
08/26/2016
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