Provider Demographics
NPI:1275061327
Name:GONS, MAGGIE (SLP)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:GONS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:HINKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:5132 SCHUYLKILL ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2551
Mailing Address - Country:US
Mailing Address - Phone:614-989-9461
Mailing Address - Fax:
Practice Address - Street 1:5132 SCHUYLKILL ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2551
Practice Address - Country:US
Practice Address - Phone:614-989-9461
Practice Address - Fax:614-989-9461
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
OHSP8551235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist