Individual
CELESZ-NICCO BAENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 KAMOKILA BLVD STE 210, KAPOLEI, HI 96707-2096
(808) 591-6060
Mailing address
1001 KAMOKILA BLVD STE 210, KAPOLEI, HI 96707-2096
(808) 591-6060
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA-565-0
HI
106S00000X
Behavior Technician
RBT-19-82824
HI
Other
Enumeration date
04/03/2019
Last updated
05/08/2023
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