Individual
WESLEY J MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MBA, MSW
Contact information
Practice address
2929 WILDWOOD ST, BOISE, ID 83713-5072
(208) 608-8375
Mailing address
2929 WILDWOOD ST, BOISE, ID 83713-5072
(208) 608-8375
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-38700
ID
Other
Enumeration date
01/26/2023
Last updated
02/11/2023
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