Provider Demographics
NPI:1811466196
Name:MAEWEATHER, YAUNDI
Entity type:Individual
Prefix:
First Name:YAUNDI
Middle Name:
Last Name:MAEWEATHER
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 1:25210 S WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:SUN LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-6408
Mailing Address - Country:US
Mailing Address - Phone:480-678-2730
Mailing Address - Fax:
Practice Address - Street 1:43284 W ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-8236
Practice Address - Country:US
Practice Address - Phone:520-350-4697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator