Provider Demographics
NPI:1073038097
Name:MAYNOR, KAREN (RBT, BCABA, LABA)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:MAYNOR
Suffix:
Gender:F
Credentials:RBT, BCABA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 RAINTREE RD STE C
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-3749
Mailing Address - Country:US
Mailing Address - Phone:757-292-4162
Mailing Address - Fax:818-758-8015
Practice Address - Street 1:4020 RAINTREE RD STE C
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3749
Practice Address - Country:US
Practice Address - Phone:757-292-4162
Practice Address - Fax:818-758-8015
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
VA0134000286106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician