# MAXINE C. GAYLORD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1396040721
- **Gender:** F
- **Credential:** L.C.S.W, BCD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 102L00000X | Psychoanalyst | — | NULL | Yes |

## Other

- **Enumeration date:** 01/15/2011
- **Last updated:** 01/15/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | PR-026241 | LICENSSED CLINICAL SOCIAL WORKER | NY |