Provider Demographics
NPI:1124437264
Name:AMAYA-HODGES, MEREDITH (PHD)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:AMAYA-HODGES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:
Other - Last Name:AMAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:47 MANSFIELD STREET
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-3101
Mailing Address - Country:US
Mailing Address - Phone:781-654-8112
Mailing Address - Fax:781-654-8121
Practice Address - Street 1:745 HIGH ST
Practice Address - Street 2:STE. 205
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090
Practice Address - Country:US
Practice Address - Phone:781-654-8112
Practice Address - Fax:781-654-8121
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01455103G00000X, 103TC2200X
MA10592103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent