Provider Demographics
NPI:1891092169
Name:MAES, ERIN (BCBA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MAES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1396 COLORADO TRL
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-8310
Mailing Address - Country:US
Mailing Address - Phone:919-356-3254
Mailing Address - Fax:
Practice Address - Street 1:1396 COLORADO TRL
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-8310
Practice Address - Country:US
Practice Address - Phone:919-356-3254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst