Individual
GORDON E MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
343 UPPER DEPOT RD, MARSHFIELD, VT 05658-4417
(208) 660-2943
Mailing address
343 UPPER DEPOT RD, MARSHFIELD, VT 05658-4417
(208) 660-2943
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
089.0001280
VT
Other
Enumeration date
10/23/2006
Last updated
06/26/2024
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