Basic Information
| Provider Information | |||||||||
| NPI: | 1316328156 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANK | ||||||||
| FirstName: | MATHEW | ||||||||
| MiddleName: | EVAN | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ED.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 WARD AVE STE 219B | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968144003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085851424 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 139 HOOWAIWAI LOOP APT 2606 | ||||||||
| Address2: | |||||||||
| City: | WAILUKU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967934132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082762417 | ||||||||
| FaxNumber: | 8084429816 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2015 | ||||||||
| LastUpdateDate: | 09/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | BA176 | HI | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.