Provider Demographics
NPI:1275092645
Name:RABARA, ANN
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:RABARA
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 1:1451 HAPUU LOOP
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-6010
Mailing Address - Country:US
Mailing Address - Phone:254-661-2945
Mailing Address - Fax:
Practice Address - Street 1:1451 HAPUU LOOP
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-6010
Practice Address - Country:US
Practice Address - Phone:254-661-2945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician