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Individual

MRS. MELISSA FATIMA MAYNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-6065
Mailing address
6623 133RD ST E, PUYALLUP, WA 98373-6316
(253) 538-7303

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60013965
WA
101YM0800X
Mental Health Counselor
LH60088360
WA
106H00000X
Marriage & Family Therapist
Primary
LF60143370
WA

Other

Enumeration date
07/07/2008
Last updated
02/21/2019
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