Healthcare Provider Details

I. General information

NPI: 1841556362
Provider Name (Legal Business Name): FLAVIA MIRIAM PLOOG FLAVIA PLOOG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: FLAVIA MIRIAM PLOOG MS ED, BCBA

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46-1033 EMEPELA WAY APT 16B
KANEOHE HI
96744-3911
US

IV. Provider business mailing address

46-1033 EMEPELA WAY APT 16B
KANEOHE HI
96744-3911
US

V. Phone/Fax

Practice location:
  • Phone: 267-648-4808
  • Fax:
Mailing address:
  • Phone: 267-648-4808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number181
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: