Provider Demographics
NPI:1871578153
Name:LERER, PAMELA BATSON (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:BATSON
Last Name:LERER
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 1:1251 NILLES RD
Mailing Address - Street 2:# 7 CLOCK TOWER PLACE
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-7206
Mailing Address - Country:US
Mailing Address - Phone:513-829-7111
Mailing Address - Fax:513-829-7114
Practice Address - Street 1:1251 NILLES RD
Practice Address - Street 2:# 7 CLOCK TOWER PLACE
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7206
Practice Address - Country:US
Practice Address - Phone:513-829-7111
Practice Address - Fax:513-829-7114
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP0061235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000317263OtherANTHEM BC & BS
OH9996643OtherBCMH, STATE OF OH
OHSP133OtherHUMANA