Provider Demographics
NPI:1134908825
Name:ST. MARKS'S THERAPY CENTER
Entity type:Organization
Organization Name:ST. MARKS'S THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST - CEO/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROCKTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:419-708-2501
Mailing Address - Street 1:6008 N CHANTICLEER DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1302
Mailing Address - Country:US
Mailing Address - Phone:419-708-2501
Mailing Address - Fax:
Practice Address - Street 1:6008 N CHANTICLEER DR
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1302
Practice Address - Country:US
Practice Address - Phone:419-708-2501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty