Individual
MAITLAND MARIE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4680 HOMINY RIDGE RD, SPRINGFIELD, OH 45502-8031
(937) 360-3725
Mailing address
4680 HOMINY RIDGE RD, SPRINGFIELD, OH 45502-8031
(937) 360-3725
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0003031
OH
Other
Enumeration date
02/02/2022
Last updated
02/02/2022
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