Provider Demographics
NPI:1699248518
Name:MAYNARD, CHERIE
Entity type:Individual
Prefix:
First Name:CHERIE
Middle Name:
Last Name:MAYNARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHERIE
Other - Middle Name:
Other - Last Name:HOARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:89 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-1483
Mailing Address - Country:US
Mailing Address - Phone:802-388-6751
Mailing Address - Fax:802-818-3388
Practice Address - Street 1:67 CATAMOUNT PARK
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1397
Practice Address - Country:US
Practice Address - Phone:802-388-6751
Practice Address - Fax:802-388-8183
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT146.0134130103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst