Individual
GABRIELLE MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1101
(314) 206-3700
Mailing address
4450 GIBSON AVE # 1F, SAINT LOUIS, MO 63110-1614
(304) 380-3386
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2025001670
MO
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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