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General NPI Number Information
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NPI Number | 1366205155
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Entity Type | Organization
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Legal Business Name | KAKOU BEHAVIORAL THERAPY, LLC
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 987 QUEEN ST APT 513
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City | HONOLULU
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State | HI
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Zip | 96814-5264
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Country | US
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Telephone | 808-224-4102
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Fax |
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Provider Business Mailing Address
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Address Line | 987 QUEEN ST APT 513
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City | HONOLULU
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State | HI
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Zip | 96814-5264
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Country | US
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Telephone | 808-224-4102
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Fax |
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Authorized Official
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Title or Position | OWNER / CLINICAL DIRECTOR
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Name | MAKENA MJ LAU
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Credential | BCBA
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Telephone | 808-224-4102
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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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