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General NPI Number Information
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NPI Number | 1861147357
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH & FAMILY MANAGEMENT
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 47-653 KAMEHAMEHA HWY STE 205
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City | KANEOHE
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State | HI
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Zip | 96744-4965
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Country | US
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Telephone | 808-358-2991
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Fax | 808-239-9763
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Provider Business Mailing Address
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Address Line | 47-241 HUI IWA ST APT C
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City | KANEOHE
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State | HI
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Zip | 96744-4344
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Country | US
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Telephone | 808-358-2991
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEESHA-ANN DOMINGO
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Credential |
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Telephone | 808-358-2991
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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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