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Individual

MRS. PAIGE RENEE MAYNARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.S, IECE, TVI

Contact information

Practice address
1906 GOLDSMITH LN, LOUISVILLE, KY 40218-2066
(502) 636-0024
(502) 498-2954
Mailing address
1906 GOLDSMITH LN, LOUISVILLE, KY 40218-2066
(502) 636-0024
(502) 498-2954

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
PENDING
KY
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
09/14/2011
Last updated
05/25/2016
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