Individual
JON BAMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA, LBA
Contact information
Practice address
65-1692 KOHALA MOUNTAIN RD, KAMUELA, HI 96743-8476
(808) 300-9059
Mailing address
67-1185 MAMALAHOA HWY D104 PMB115, KAMUELA, HI 96743
(808) 300-9059
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA-725
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93-2028125
—
HI
Enumeration date
12/28/2017
Last updated
10/06/2023
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