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NPI Code Detail

MEDICARE: MRS. DIANNA LEE BCBA

MEDICARE:  MRS. DIANNA  LEE  BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystBA-97HI

General Provider Information

NPI Number : 1538580519
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANNA LEE BCBA
Provider Business Mailing Address
First Line : 420 WAIAKAMILO RD STE 202
Second Line :
City : HONOLULU
State : HI
Zip : 96817-4950
Country : US
Telephone Number : 808-845-0102
Fax Number : 808-442-4582
Provider Business Practice Location Address
First Line : 420 WAIAKAMILO RD STE 202
Second Line :
City : HONOLULU
State : HI
Zip : 96817-4950
Country : US
Telephone Number : 808-845-0102
Fax Number : 808-442-4582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2013
Last Update Date : 11/14/2024

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Directions to “ MRS. DIANNA LEE BCBA” Practice Location

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