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General NPI Number Information
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NPI Number | 1811779556
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Entity Type | Organization
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Legal Business Name | THE BEHAVIOR PLACE
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 1038 ULU KANU ST
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City | WAILUKU
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State | HI
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Zip | 96793-8320
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Country | US
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Telephone | 720-261-7950
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Fax |
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Provider Business Mailing Address
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Address Line | 1038 ULU KANU ST
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City | WAILUKU
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State | HI
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Zip | 96793-8320
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Country | US
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Telephone | 720-261-7950
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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 | LAURA HELLER
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Credential | BCBA
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Telephone | 720-261-7950
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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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