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Individual

MICHELLE HOTEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
25 KANEOHE BAY DR UNIT 211212, KAILUA, HI 96734-1727
(808) 388-1683
Mailing address
25 KANEOHE BAY DR UNIT 211212, KAILUA, HI 96734-1727
(808) 388-1683

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-61477
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RBT-21-15591
CREDENTIAL
Enumeration date
03/23/2021
Last updated
02/13/2024
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