Individual
ALICIA NICOLE MAYNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
296 S FERDON BLVD, CRESTVIEW, FL 32536-3702
(850) 333-1279
Mailing address
40 STATE HIGHWAY 83, DEFUNIAK SPRINGS, FL 32433-7404
(850) 585-9198
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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