Provider Demographics
NPI:1811481666
Name:RICHARDS-MAYNARD, MARIAH (MFT)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:RICHARDS-MAYNARD
Suffix:
Gender:
Credentials:MFT
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:LESLEY
Other - Last Name:RICHARDS MAYNARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 HEALTH DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-2955
Mailing Address - Country:US
Mailing Address - Phone:800-561-0861
Mailing Address - Fax:
Practice Address - Street 1:1 HEALTH DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-2955
Practice Address - Country:US
Practice Address - Phone:800-561-0861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT132371106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist