Provider Demographics
NPI:1093341349
Name:SEELY, HEATHER J (RBT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:J
Last Name:SEELY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
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Mailing Address - Street 1:3083 AKAHI ST STE 101
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1102
Mailing Address - Country:US
Mailing Address - Phone:808-245-9699
Mailing Address - Fax:808-245-5103
Practice Address - Street 1:3083 AKAHI ST STE 101
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1102
Practice Address - Country:US
Practice Address - Phone:808-245-9699
Practice Address - Fax:808-245-5103
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician