Most Relevant Information
Provider Data
| NPI Number: | 1003550245 |
| Provider Name: | MELISSA MAYNARD |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/25/2022 |
| Last Updated: | 04/25/2022 |
Provider Practice Location
125 S MAIN CROSS ST
LOUISA
KY
412301065
Practice Location Phone/Fax
| Phone: | 6066380938 |
| Fax: |
Provider Mailing Location
125 S MAIN CROSS ST
LOUISA
KY
412301065
Provider Mailing Phone/Fax
| Phone: | 6066380938 |
| Fax: |