Basic Information
| Provider Information | |||||||||
| NPI: | 1396155925 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KEIKI EDUCATIONAL CONSULTANTS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 67-216 NIUMALOO PL | ||||||||
| Address2: | |||||||||
| City: | WAIALUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967919507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082982658 | ||||||||
| FaxNumber: | 8086375960 | ||||||||
| Practice Location | |||||||||
| Address1: | 67-216 NIUMALOO PL | ||||||||
| Address2: | |||||||||
| City: | WAIALUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967919507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082982658 | ||||||||
| FaxNumber: | 8086375960 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2014 | ||||||||
| LastUpdateDate: | 05/05/2014 | ||||||||
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| AuthorizedOfficialLastName: | KELLY | ||||||||
| AuthorizedOfficialFirstName: | AMANDA | ||||||||
| AuthorizedOfficialMiddleName: | NICOLE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER, CEO | ||||||||
| AuthorizedOfficialTelephone: | 8082982658 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHD, BCBA-D | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 01-08-4140 | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.