Provider Demographics
NPI:1497387526
Name:LEDBETTER, ALLIE TRAMBOW
Entity Type:Individual
Prefix:
First Name:ALLIE
Middle Name:TRAMBOW
Last Name:LEDBETTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:
Other - Last Name:TRAMBOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95-2051 WAIKALANI PL APT E306
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-5102
Mailing Address - Country:US
Mailing Address - Phone:843-327-6523
Mailing Address - Fax:
Practice Address - Street 1:2226 LILIHA ST STE 403
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1605
Practice Address - Country:US
Practice Address - Phone:843-327-6523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician