Provider Demographics
NPI:1831574946
Name:NOEDER, MAIA (PHD)
Entity type:Individual
Prefix:
First Name:MAIA
Middle Name:
Last Name:NOEDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 DELAWARE AVE # 4422
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-4743
Mailing Address - Country:US
Mailing Address - Phone:302-321-5330
Mailing Address - Fax:
Practice Address - Street 1:1207 DELAWARE AVE # 4422
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-4743
Practice Address - Country:US
Practice Address - Phone:302-321-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100103TC2200X
DEB10001036103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent