| NPI | 1427526193 |
|---|---|
| Former Name | MACAYLA MARIE MAYNARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178.013904) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: IL 2368884) |
| Enumeration Date | 2018-11-11 |
| Last Update Date | 2018-11-11 |