Provider Demographics
NPI:1568196152
Name:TABLIT, DAYSHA
Entity Type:Individual
Prefix:
First Name:DAYSHA
Middle Name:
Last Name:TABLIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 LYMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4858
Mailing Address - Country:US
Mailing Address - Phone:808-854-9933
Mailing Address - Fax:
Practice Address - Street 1:333 LYMAN AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4858
Practice Address - Country:US
Practice Address - Phone:808-854-9933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician