Provider Demographics
NPI:1033980487
Name:ROLLING WAVE ABA, LLC
Entity Type:Organization
Organization Name:ROLLING WAVE ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:808-728-2175
Mailing Address - Street 1:45-143C WILLIAM HENRY RD # C
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3150
Mailing Address - Country:US
Mailing Address - Phone:808-728-2175
Mailing Address - Fax:
Practice Address - Street 1:45-143C WILLIAM HENRY RD # C
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3150
Practice Address - Country:US
Practice Address - Phone:808-728-2175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health