Individual
LAUREN MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2405 28TH ST, ANACORTES, WA 98221-2484
(978) 549-9522
Mailing address
104 DEERFIELD PL, ITHACA, NY 14850-1904
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041449
—
WA
Enumeration date
05/25/2017
Last updated
06/11/2019
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