| Provider / Organization | NPI | Date Certified |
|---|---|---|
| WESLEY J MAYNARD | 1700592359 | 2023-02-11 |
Wesley J Maynard is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1700592359. Registration indicates Wesley J Maynard is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Social Worker (Behavioral Health & Social Service Providers, Social Worker) (Social Worker, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Social Worker, Behavioral Health & Social Service Providers)
| Entity Type | Individual |
| Provider Name | Wesley J Maynard MBA, MSW |
| Practice Office Address | 2929 WILDWOOD ST BOISE, ID US |
| Practice Office Telephone | 2086088375 |
| Mailing Address | 2929 WILDWOOD ST BOISE, ID 837135072 US |
| Business Telephone | 2086088375 |
| Code | Practice | License No State |
|---|---|---|
| 104100000X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Social Worker Behavioral Health & Social Service Providers Social Worker Social Worker Behavioral Health/Substance Abuse/Psychiatry Social Worker Behavioral Health & Social Service Providers | LMSW-38700
ID |