Individual
JAMIE NICOLE MAYNARD-GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 S MAIN CROSS ST, LOUISA, KY 41230-1065
(606) 638-0938
Mailing address
332 RIVER BEND RD, LOUISA, KY 41230-1407
(606) 638-0938
(859) 813-5394
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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