Provider Demographics
NPI:1083936314
Name:NIKOLOVA, ANI G (PHD, LBA, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:ANI
Middle Name:G
Last Name:NIKOLOVA
Suffix:
Gender:F
Credentials:PHD, LBA, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 FARRINGTON HWY UNIT 524-226
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2009
Mailing Address - Country:US
Mailing Address - Phone:808-762-9785
Mailing Address - Fax:
Practice Address - Street 1:590 FARRINGTON HWY UNIT 524-226
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707
Practice Address - Country:US
Practice Address - Phone:808-762-9785
Practice Address - Fax:808-441-7729
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCBA-D 1-09-5027103K00000X
HI185103K00000X, 106E00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty