Provider Demographics
NPI:1508553736
Name:CHARRETON, MALENA (BS, RBT)
Entity Type:Individual
Prefix:
First Name:MALENA
Middle Name:
Last Name:CHARRETON
Suffix:
Gender:F
Credentials:BS, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-5873 WALUA RD APT D232
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-5319
Mailing Address - Country:US
Mailing Address - Phone:832-491-8134
Mailing Address - Fax:
Practice Address - Street 1:74-5078 KUMAKANI ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1530
Practice Address - Country:US
Practice Address - Phone:808-746-1779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician