Basic Information
| Provider Information | |||||||||
| NPI: | 1720735558 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EN FLEUR BEHAVIOR ANALYSIS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 614 COOKE ST STE 205 | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968135251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087793566 | ||||||||
| FaxNumber: | 8775228210 | ||||||||
| Practice Location | |||||||||
| Address1: | 614 COOKE ST STE 205 | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968135251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087793566 | ||||||||
| FaxNumber: | 8775228210 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2022 | ||||||||
| LastUpdateDate: | 03/02/2022 | ||||||||
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| AuthorizedOfficialLastName: | RODRIGUEZ | ||||||||
| AuthorizedOfficialFirstName: | JOELLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/BEHAVIOR ANALYST | ||||||||
| AuthorizedOfficialTelephone: | 8087793566 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.ED., BCBA, LBA | ||||||||
| NPICertificationDate: | 03/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.