Provider Demographics
NPI:1548755291
Name:HANLIN, COURTNEY C (MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:C
Last Name:HANLIN
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 KUHIO AVE APT 402
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-2305
Mailing Address - Country:US
Mailing Address - Phone:248-508-7025
Mailing Address - Fax:
Practice Address - Street 1:1130 ALA MOANA BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:248-508-7025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBA-659-0103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst