Individual
ELLEN MACKOWIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SP
Contact information
Practice address
1560 HENTHORNE DR, MAUMEE, OH 43537-1371
(419) 866-5275
(419) 866-5663
Mailing address
1560 HENTHORNE DR, MAUMEE, OH 43537-1371
(419) 866-5275
(419) 866-5663
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP8218
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609899061
CORP NPI NUMBER
OH
05
—
2526654
—
OH
Enumeration date
04/10/2007
Last updated
07/08/2007
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