Provider Demographics
NPI:1447384953
Name:YEH, WELLI (PHD)
Entity Type:Individual
Prefix:DR
First Name:WELLI
Middle Name:
Last Name:YEH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:WELLI
Other - Middle Name:YEH
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:32 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2714
Mailing Address - Country:US
Mailing Address - Phone:413-586-8413
Mailing Address - Fax:
Practice Address - Street 1:15 GOTHIC ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3059
Practice Address - Country:US
Practice Address - Phone:413-586-8413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6108103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW50252Medicare ID - Type Unspecified