Provider Demographics
NPI:1073299129
Name:IRLAS, PAULA MARIA
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIA
Last Name:IRLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 ALOHIKEA ST UNIT 1016
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-4684
Mailing Address - Country:US
Mailing Address - Phone:808-859-0725
Mailing Address - Fax:
Practice Address - Street 1:1055 ALOHIKEA ST UNIT 1016
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4684
Practice Address - Country:US
Practice Address - Phone:808-859-0725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician