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Individual
ROXANNE MAYNARD
Active
Individual
ROXANNE MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCDC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
73188
TX
101YP2500X
Professional Counselor
5444
OK
101YP2500X
Professional Counselor
Primary
73188
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
351033101
—
TX
Enumeration date
07/24/2012
Last updated
09/04/2018
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