Doctor Name: | TERRY MAYNES |
NPI Number: | 1124351911 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 0121561 |
Business Practice Address: | 310 W 6th St Silver City, NM - 880615001 |
Business Phone Number: | 5753133698 |
Business Fax Number: | |
Mailing Address: | 310 W 6th St, SILVER CITY |
State: | NM |
Postal Code: | 880615001 |
Phone Number: | 5753133698 |
Fax Number: | |
NPI Enumeration Date: | 09/10/2009 |
NPI Last Update Date: | 09/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0121561 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |