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Individual

KATHLEEN MICHELLE MAYNARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, ALPS, AADC

Contact information

Practice address
800 20TH ST, HUNTINGTON, WV 25703-1850
(304) 696-8700
(304) 696-8701
Mailing address
800 20TH ST, HUNTINGTON, WV 25703-1850
(304) 696-8700
(304) 696-8701

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13-301
WV
101YM0800X
Mental Health Counselor
Primary
2439
WV

Other

Enumeration date
11/25/2020
Last updated
11/24/2021
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