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1205545316
JAMIE NICOLE MAYNARD-GILLIAM
LOUISA, KY
NPI
1205545316
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-11-17
Last Update Date
2022-11-17
Business Address
JAMIE NICOLE MAYNARD-GILLIAM
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
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Mailing Address
JAMIE NICOLE MAYNARD-GILLIAM
332 RIVER BEND RD
LOUISA, KY 41230-1407
Phone number: 606-638-0938
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