Individual
CICELY MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
,QP, MA LPC-A
Contact information
Practice address
2670 DURHAM CHAPEL HILL BLVD, DURHAM, NC 27707-2829
(919) 251-9001
Mailing address
2670 DURHAM CHAPEL HILL BLVD, DURHAM, NC 27707-2829
(919) 251-9001
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A12142
NC
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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