Provider Demographics
NPI:1649065335
Name:YEBOAH, ADU
Entity type:Individual
Prefix:MR
First Name:ADU
Middle Name:
Last Name:YEBOAH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PLEASANT ST APT 301
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1341
Mailing Address - Country:US
Mailing Address - Phone:508-373-4750
Mailing Address - Fax:
Practice Address - Street 1:5 PLEASANT ST APT 301
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1341
Practice Address - Country:US
Practice Address - Phone:508-373-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor