Individual provider · Type 1 NPI
Roxanne Maynard, LPC, LCDC
Professional Counselor · San Antonio, TX
NPI number
1407102718
Active
Practice location
4203 Gardendale St Ste C214
San Antonio, TX 78229
Fax (877) 287-0053
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | 73188 (TX) |
| Professional Counselor | 101YP2500X | 5444 (OK) |
| Professional Counselor Primary | 101YP2500X | 73188 (TX) |
Professional Counselor: Definition to come...
2 other providers at this address
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About NPI 1407102718
Roxanne Maynard, LPC, LCDC's National Provider Identifier is 1407102718, issued on Jul 24, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in San Antonio, TX. The record was last updated on Sep 4, 2018.