Provider Demographics
NPI:1376703629
Name:LEE, YURI HASEGAWA (BCBA)
Entity Type:Individual
Prefix:
First Name:YURI
Middle Name:HASEGAWA
Last Name:LEE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:YURI
Other - Middle Name:
Other - Last Name:HASEGAWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:1009 KAPIOLANI BLVD APT 2607
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2168
Mailing Address - Country:US
Mailing Address - Phone:615-293-4466
Mailing Address - Fax:808-888-7231
Practice Address - Street 1:1009 KAPIOLANI BLVD APT 2607
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2168
Practice Address - Country:US
Practice Address - Phone:615-293-4466
Practice Address - Fax:808-888-7231
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral