Individual
TRACI MAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
308 BARNES RD, WILLIAMSTOWN, KY 41097-9483
(859) 824-4442
Mailing address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 578-3204
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6629
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610661458
TAX ID
KY
Enumeration date
05/13/2013
Last updated
05/13/2013
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