Provider Demographics
NPI:1598372468
Name:OHANA ABA CONSULTING, LLC
Entity Type:Organization
Organization Name:OHANA ABA CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BCBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:PANNEBAKER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:719-469-4906
Mailing Address - Street 1:813 RANDALL AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-2559
Mailing Address - Country:US
Mailing Address - Phone:719-469-4906
Mailing Address - Fax:307-202-4557
Practice Address - Street 1:813 RANDALL AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-2559
Practice Address - Country:US
Practice Address - Phone:719-469-4906
Practice Address - Fax:307-202-4557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty