Provider Demographics
NPI:1881396844
Name:SPEIGHT, MAURINE CECILIA
Entity type:Individual
Prefix:
First Name:MAURINE
Middle Name:CECILIA
Last Name:SPEIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E TOWN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4657
Mailing Address - Country:US
Mailing Address - Phone:614-412-1002
Mailing Address - Fax:614-358-9792
Practice Address - Street 1:230 E TOWN ST STE 210
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4657
Practice Address - Country:US
Practice Address - Phone:614-412-1002
Practice Address - Fax:614-358-9792
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty