Provider Demographics
NPI:1346805751
Name:GRAHAM, MICHELLE KUUIPO KALUA (BCBA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:KUUIPO KALUA
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 LAWELAWE ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1770
Mailing Address - Country:US
Mailing Address - Phone:808-681-2178
Mailing Address - Fax:855-975-2866
Practice Address - Street 1:944 LAWELAWE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1770
Practice Address - Country:US
Practice Address - Phone:808-681-2178
Practice Address - Fax:855-975-2866
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBA-493103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst