Healthcare Provider Details

I. General information

NPI: 1992639207
Provider Name (Legal Business Name): MAGGIE GHOTBI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 E CAPITOL ST SE
WASHINGTON DC
20019-6772
US

IV. Provider business mailing address

1630 COLUMBIA RD NW APT 901
WASHINGTON DC
20009-3648
US

V. Phone/Fax

Practice location:
  • Phone: 202-559-6138
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLPCF2000190
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: