Organization
SANDWELL ABA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SANDWELL MA, BCBA (CLINICAL DIRECTOR)
(858) 247-1828
Entity
Organization
Contact information
Practice address
95-390 KUAHELANI AVE, SUITE 3AC #1082, MILILANI, HI 96789-1190
(858) 247-1828
Mailing address
95-390 KUAHELANI AVE, SUITE 3AC #1082, MILILANI, HI 96789-1190
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA-136
HI
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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