Individual
ELIZABETH MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
508 MARBLEGATE CIR, ALVATON, KY 42122-8751
(954) 629-3805
Mailing address
508 MARBLEGATE CIR, ALVATON, KY 42122-8751
(954) 629-3805
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
06/22/2024
Last updated
03/04/2025
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