| NPI | 1033633219 |
|---|---|
| Former Name | HALEY SHAE MAYNARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KY 254621) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 252654) |
| 1041C0700X Social Worker, Clinical (Licence: KY 254621) | |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2023-11-08 |