Healthcare Provider Details

I. General information

NPI: 1811368574
Provider Name (Legal Business Name): BEHAVIOR ANALYSIS NO KA OI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2015
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 SOUTH ST
HONOLULU HI
96813-5013
US

IV. Provider business mailing address

564 SOUTH ST
HONOLULU HI
96813-5013
US

V. Phone/Fax

Practice location:
  • Phone: 808-591-1173
  • Fax: 808-591-1174
Mailing address:
  • Phone: 808-591-1173
  • Fax: 808-591-1174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: CHAD WALTON
Title or Position: MANAGER
Credential:
Phone: 808-489-2543