Healthcare Provider Details

I. General information

NPI: 1871149435
Provider Name (Legal Business Name): DANIELLE NICOLE KILA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2019
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 GREEN ST
HONOLULU HI
96813-2119
US

IV. Provider business mailing address

91-1544 LAUPAE ST
EWA BEACH HI
96706-4873
US

V. Phone/Fax

Practice location:
  • Phone: 808-536-1015
  • Fax:
Mailing address:
  • Phone: 808-953-4115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-95429
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: