Provider Demographics
NPI:1992840433
Name:VENT, MAGGIE (PCC)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:VENT
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:A
Other - Last Name:VENT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PCC
Mailing Address - Street 1:601 S EDWIN C MOSES BLVD
Mailing Address - Street 2:4TH FLOOR NW BLDG
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3424
Mailing Address - Country:US
Mailing Address - Phone:937-440-7021
Mailing Address - Fax:937-440-7076
Practice Address - Street 1:601 S EDWIN C MOSES BLVD
Practice Address - Street 2:4TH FLOOR NW BLDG
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3424
Practice Address - Country:US
Practice Address - Phone:937-734-4333
Practice Address - Fax:937-440-7076
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2014-03-06
Deactivation Date:2007-03-13
Deactivation Code:
Reactivation Date:2007-05-09
Provider Licenses
StateLicense IDTaxonomies
OHE2854101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional