Basic Information
Provider Information
NPI: 1972708949
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAGUSCHAK
FirstName: MARIANN
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: M.A. CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6157 SCIOTO PKWY
Address2:  
City: POWELL
State: OH
PostalCode: 430658554
CountryCode: US
TelephoneNumber: 6143124575
FaxNumber: 6145297121
Practice Location
Address1: 5471 SCIOTO DARBY RD
Address2:  
City: HILLIARD
State: OH
PostalCode: 430261310
CountryCode: US
TelephoneNumber: 6148767356
FaxNumber: 6145297121
Other Information
ProviderEnumerationDate: 06/19/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XSP4662OHY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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