Healthcare Provider Details

I. General information

NPI: 1508402827
Provider Name (Legal Business Name): EN FLEUR BEHAVIOR ANALYSIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 07/01/2024
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45-130 MAHALANI CIR
KANEOHE HI
96744-2718
US

IV. Provider business mailing address

45-130 MAHALANI CIR
KANEOHE HI
96744-2718
US

V. Phone/Fax

Practice location:
  • Phone: 808-779-3566
  • Fax: 877-522-8210
Mailing address:
  • Phone: 808-779-3566
  • Fax: 877-522-8210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOELLE RODRIGUEZ
Title or Position: OWNER
Credential: M.ED, BCBA, LBA
Phone: 808-779-3566