Healthcare Provider Details

I. General information

NPI: 1275061327
Provider Name (Legal Business Name): MAGGIE GONS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAGGIE HINKEL SLP

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 06/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5132 SCHUYLKILL ST
COLUMBUS OH
43220-2551
US

IV. Provider business mailing address

5132 SCHUYLKILL ST
COLUMBUS OH
43220-2551
US

V. Phone/Fax

Practice location:
  • Phone: 614-989-9461
  • Fax: 614-989-9461
Mailing address:
  • Phone: 614-989-9461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP8551
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: