Elizabeth Maynard

Individual provider Active NPI Behavior Technician · Alvaton, KY

NPI 1730923905 · NPPES record last updated Mar 4, 2025

Key facts

NPI
1730923905
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
508 Marblegate Cir
Alvaton, KY 42122-8751
Phone
(954) 629-3805
NPI assigned
Jun 22, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

508 Marblegate Cir
Alvaton, KY 42122-8751

Mailing address

508 Marblegate Cir
Alvaton, KY 42122-8751
Phone (954) 629-3805

Other providers in Alvaton, KY

All providers in Alvaton, KY · Behavior Technician in Kentucky

Sources for this page

Verify at the official NPI Registry.