Healthcare Provider Details

I. General information

NPI: 1326959909
Provider Name (Legal Business Name): CHARITY WEAVER-PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-539 PUAHI ST
WAIPAHU HI
96797-6200
US

IV. Provider business mailing address

198 KAROPCZYC CT # 96786
WAHIAWA HI
96786-6000
US

V. Phone/Fax

Practice location:
  • Phone: 808-591-6060
  • Fax:
Mailing address:
  • Phone: 808-591-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2844454
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: