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General NPI Number Information
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NPI Number | 1215545991
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Entity Type | Organization
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Legal Business Name | AUTISM INTERVENTION MANAGEMENT INCORPORATED
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 07/17/2020
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Provider Practice Location Address
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Address Line | 55 S KUKUI ST APT 3211
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City | HONOLULU
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State | HI
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Zip | 96813-2327
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Country | US
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Telephone | 808-393-9826
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Fax |
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Provider Business Mailing Address
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Address Line | 55 S KUKUI ST APT 3211
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City | HONOLULU
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State | HI
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Zip | 96813-2327
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Country | US
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Telephone | 808-393-9826
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DIANNA ATAY
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Credential | BCBA
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Telephone | 808-393-9826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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