Individual
CAETLEN MANDEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
94-849 LUMIAINA ST UNIT 201, WAIPAHU, HI 96797-5677
(855) 223-7123
Mailing address
PO BOX 33568, SAN DIEGO, CA 92163-3568
(855) 223-7123
(619) 374-7134
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-21-51442
CO
103K00000X
Behavior Analyst
Primary
BA-802
HI
Other
Enumeration date
05/11/2018
Last updated
10/18/2023
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