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General NPI Number Information
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NPI Number | 1215660063
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Entity Type | Individual
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Provider Name | KIMBERLY DANIELLE DONNELLY RBT
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Gender | Female
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Dates
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Enumeration Date | 07/07/2022
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 9030 BORDELON LOOP
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City | KAILUA
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State | HI
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Zip | 96734-5438
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Country | US
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Telephone | 252-424-9148
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 KAMOKILA BLVD STE 210
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City | KAPOLEI
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State | HI
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Zip | 96707-2096
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Country | US
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Telephone | 252-424-9148
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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