| Doctor Name: | DR. KARI MICHELLE-FERBER MAYNARD |
| NPI Number: | 1013357797 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | LP4979 |
| Business Practice Address: | 520 2nd Ave Se Pine City, MN - 550631505 |
| Business Phone Number: | 3203225130 |
| Business Fax Number: | |
| Mailing Address: | 520 2nd Ave Se, PINE CITY |
| State: | MN |
| Postal Code: | 550631505 |
| Phone Number: | 3203225130 |
| Fax Number: | |
| NPI Enumeration Date: | 06/26/2013 |
| NPI Last Update Date: | 09/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0400X |
| License Number: | LP4979 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |