Individual
LATANYA RENEE MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1131 W 32ND ST, JACKSONVILLE, FL 32209-4094
(904) 866-5717
Mailing address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-7797
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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