Individual
JEREMY MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8417 US ROUTE 60 STE 8, BARBOURSVILLE, WV 25504-7662
(304) 963-1964
Mailing address
PO BOX 109, CEREDO, WV 25507-0109
(304) 963-1964
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/02/2026
Last updated
01/02/2026
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