Provider Demographics
NPI:1699515585
Name:GIROUX, MAILE LILLIAN
Entity type:Individual
Prefix:
First Name:MAILE
Middle Name:LILLIAN
Last Name:GIROUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-3229
Mailing Address - Country:US
Mailing Address - Phone:531-289-9554
Mailing Address - Fax:
Practice Address - Street 1:1415 MALSTEAD WAY
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-4065
Practice Address - Country:US
Practice Address - Phone:531-289-9554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician