Provider Demographics
NPI:1598161671
Name:POSITIVE BEHAVIORAL INTERVENTIONS
Entity Type:Organization
Organization Name:POSITIVE BEHAVIORAL INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOELLE
Authorized Official - Middle Name:ILIMA MEI-LIN
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MED BCBA
Authorized Official - Phone:808-779-3566
Mailing Address - Street 1:614 COOKE ST STE 205
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5251
Mailing Address - Country:US
Mailing Address - Phone:808-779-3566
Mailing Address - Fax:
Practice Address - Street 1:614 COOKE ST STE 205
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5251
Practice Address - Country:US
Practice Address - Phone:808-779-3566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1118832251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1851664957OtherTRICARE