Healthcare Provider Details

I. General information

NPI: 1043536709
Provider Name (Legal Business Name): KIU AMANI EUBANKS PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 FIRST ST
CAMBRIDGE MA
02142-1200
US

IV. Provider business mailing address

1339 GREENBRIAR CIR # 8
PIKESVILLE MD
21208-3750
US

V. Phone/Fax

Practice location:
  • Phone: 443-900-7329
  • Fax:
Mailing address:
  • Phone: 443-900-7329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY10000379
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number05244
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: