Provider Demographics
NPI:1558033522
Name:KUMAR, YAMINI
Entity type:Individual
Prefix:
First Name:YAMINI
Middle Name:
Last Name:KUMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-2734
Mailing Address - Country:US
Mailing Address - Phone:978-496-4081
Mailing Address - Fax:
Practice Address - Street 1:20 MAIN ST
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3575
Practice Address - Country:US
Practice Address - Phone:978-263-1427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-24-72970103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst