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NPI Code Detail

MEDICARE: EMILY KATHERINE MAYNARD

MEDICARE: EMILY KATHERINE MAYNARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1376437582
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY KATHERINE MAYNARD
Provider Business Mailing Address
First Line : 150 E DARTMOOR DR
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-8710
Country : US
Telephone Number : 630-569-4926
Fax Number :
Provider Business Practice Location Address
First Line : 150 E DARTMOOR DR
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-8710
Country : US
Telephone Number : 630-569-4926
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2025
Last Update Date : 06/04/2025

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Directions to “ EMILY KATHERINE MAYNARD ” Practice Location

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