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General NPI Number Information
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NPI Number | 1427940402
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Entity Type | Individual
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Provider Name | MADISEN GRACE BAKER
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Gender | Female
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 94-539 PUAHI ST
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City | WAIPAHU
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State | HI
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Zip | 96797-6200
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Country | US
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Telephone | 808-591-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 5485 KOLOA RD UNIT 156
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City | KOLOA
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State | HI
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Zip | 96756-3008
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Country | US
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Telephone | 832-226-3177
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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 | HI
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