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General NPI Number Information
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NPI Number | 1174153415
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Entity Type | Organization
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Legal Business Name | BALANCED ABA
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Dates
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Enumeration Date | 01/24/2020
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Last Update Date | 02/09/2020
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Provider Practice Location Address
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Address Line | 98-820 MOANALUA RD SPACE 5 PMB 161
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City | AIEA
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State | HI
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Zip | 96701
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Country | US
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Telephone | 808-845-6080
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Fax | 808-845-6081
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Provider Business Mailing Address
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Address Line | 98-820 MOANALUA RD SPACE 5 PMB 161
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City | AIEA
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State | HI
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Zip | 96701
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Country | US
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Telephone | 808-845-6080
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Fax | 808-845-6080
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Authorized Official
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Title or Position | CEO
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Name | MS. SHANDA STRICKLAND
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Credential | BCBA, LBA
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Telephone | 808-845-6080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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