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General NPI Number Information
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NPI Number | 1861032880
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Entity Type | Individual
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Provider Name | CECELIA KIM
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Gender | Female
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 2 AARONA PL STE 208
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City | KAILUA
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State | HI
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Zip | 96734-2545
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Country | US
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Telephone | 808-263-5521
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Fax |
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Provider Business Mailing Address
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Address Line | 98-1481 KAAHUMANU ST # B145
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City | AIEA
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State | HI
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Zip | 96701-2048
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Country | US
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Telephone | 808-372-3495
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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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