Provider Demographics
NPI:1841598158
Name:MAYNARD, GINGER E (OT)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:E
Last Name:MAYNARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 INDUSTRIAL DR E
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-3326
Mailing Address - Country:US
Mailing Address - Phone:903-885-9906
Mailing Address - Fax:903-438-9636
Practice Address - Street 1:1129 INDUSTRIAL DR E
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-3326
Practice Address - Country:US
Practice Address - Phone:903-885-9906
Practice Address - Fax:903-438-9636
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109367225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand