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Individual

DR. JESSIE M MAYNARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LP, PSYD, CAADC

Contact information

Practice address
1199 TEAKWOOD CIR, HASLETT, MI 48840-9734
(202) 630-2790
Mailing address
1199 TEAKWOOD CIR, HASLETT, MI 48840-9734
(202) 630-2790

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-00917
MI
101YM0800X
Mental Health Counselor
6301015286
MI
103TC0700X
Clinical Psychologist
Primary
6301015286
MI
103TP2701X
Group Psychotherapy Psychologist
6301015286
MI

Other

Enumeration date
02/15/2009
Last updated
05/12/2025
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