Provider Demographics
NPI:1023537172
Name:MAEDA, YUKI (MA)
Entity type:Individual
Prefix:
First Name:YUKI
Middle Name:
Last Name:MAEDA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MALLARD DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3546
Mailing Address - Country:US
Mailing Address - Phone:603-321-5175
Mailing Address - Fax:978-418-1081
Practice Address - Street 1:265 CHELMSFORD ST.
Practice Address - Street 2:STE 7 #1003
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824
Practice Address - Country:US
Practice Address - Phone:603-321-5175
Practice Address - Fax:978-418-1081
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-10
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NH1-18-33220103K00000X
MA2620103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1-18-33220OtherBCBA
MA2620OtherLABA