Individual
MS. SUSANNE LYNN MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW,MT-BC
Contact information
Practice address
203 E MAPLE ST, KEENE, TX 76059-2351
(817) 897-5598
Mailing address
203 E MAPLE ST, KEENE, TX 76059-2351
(817) 897-5598
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
59606
TX
171M00000X
Case Manager/Care Coordinator
59606
TX
225A00000X
Music Therapist
08861
TX
Other
Enumeration date
04/15/2011
Last updated
02/03/2015
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