Individual
MR. GLENN C MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1020 SW TAYLOR ST, SUITE 370, PORTLAND, OR 97205-2543
(503) 295-6265
(503) 232-1969
Mailing address
1020 SW TAYLOR ST, SUITE 370, PORTLAND, OR 97205-2543
(503) 295-6265
(503) 232-1969
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C0084
OR
Other
Enumeration date
03/07/2008
Last updated
02/03/2009
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