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MR. EMMANUEL GEORGE MAIZE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
225 W BRECKINRIDGE ST, LOUISVILLE, KY 40203-2219
(502) 561-1051
(502) 587-7145
Mailing address
225 W BRECKINRIDGE ST, LOUISVILLE, KY 40203-2219
(502) 561-1051
(502) 587-7145

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
172V00000X
Community Health Worker
1389
KY

Other

Enumeration date
07/21/2011
Last updated
12/18/2012
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