Provider Demographics
NPI:1669296927
Name:DROCKTON, GREGORY (SLP)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:DROCKTON
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:440-409-9300
Mailing Address - Fax:
Practice Address - Street 1:935 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-2332
Practice Address - Country:US
Practice Address - Phone:440-409-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.16192235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist