Healthcare Provider Details

I. General information

NPI: 1245426865
Provider Name (Legal Business Name): AMY D.S. GEBHARD BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY DANIELLE WIECH

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2969 MAPUNAPUNA PL STE 200
HONOLULU HI
96819-2000
US

IV. Provider business mailing address

2969 MAPUNAPUNA PL STE 200
HONOLULU HI
96819-2000
US

V. Phone/Fax

Practice location:
  • Phone: 808-277-7736
  • Fax:
Mailing address:
  • Phone: 808-277-7736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA-34
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: