Individual
MS. AUDREY RAE MAYNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M..ED., LPC
Contact information
Practice address
150 GLENWOOD LN, BIRMINGHAM, AL 35242-5700
(205) 795-3214
Mailing address
1029 HENRY DR, ALABASTER, AL 35007-8947
(205) 240-2372
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
2238
AL
Other
Enumeration date
10/19/2010
Last updated
10/19/2010
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