Healthcare Provider Details

I. General information

NPI: 1396155925
Provider Name (Legal Business Name): KEIKI EDUCATIONAL CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67-216 NIUMALOO PL
WAIALUA HI
96791-9507
US

IV. Provider business mailing address

67-216 NIUMALOO PL
WAIALUA HI
96791-9507
US

V. Phone/Fax

Practice location:
  • Phone: 808-298-2658
  • Fax: 808-637-5960
Mailing address:
  • Phone: 808-298-2658
  • Fax: 808-637-5960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number01-08-4140
License Number State

VIII. Authorized Official

Name: DR. AMANDA NICOLE KELLY
Title or Position: OWNER, CEO
Credential: PHD, BCBA-D
Phone: 808-298-2658