Provider Demographics
NPI:1194035733
Name:LIBBY, CHRISTINA MARIA (BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIA
Last Name:LIBBY
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41-611 INOAOLE ST
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1211
Mailing Address - Country:US
Mailing Address - Phone:808-892-4059
Mailing Address - Fax:808-260-4391
Practice Address - Street 1:41-611 INOAOLE ST
Practice Address - Street 2:
Practice Address - City:WAIMANALO
Practice Address - State:HI
Practice Address - Zip Code:96795-1211
Practice Address - Country:US
Practice Address - Phone:808-892-4059
Practice Address - Fax:808-260-4391
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBA-31103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst