MS. Staci Beth Maynard, PROVISIONALTVI
MS. Staci Beth Maynard, PROVISIONALTVI is a Developmental Therapist in Louisville, Kentucky. Licensed in Kentucky. Registered with an NPI since 2018.
- Licensed in
- KY
- In the registry since
- 2018
Practice location Address checks out
1906 Goldsmith LnLouisville, KY 40218-2066
Phone: (502) 636-3207
Fax: (502) 636-0024
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Developmental Therapist (primary) | Taxonomy 222Q00000X (KY) |
|---|
Record details
| NPI number | 1972086031 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PROVISIONALTVI |
| Sole proprietor | No |
| NPI enumerated | September 13, 2018 |
| Last updated in NPPES | September 13, 2018 |
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