Provider Demographics
NPI:1619556362
Name:LEW, KAYLIN PUI KUEN
Entity Type:Individual
Prefix:
First Name:KAYLIN
Middle Name:PUI KUEN
Last Name:LEW
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 1:67-433 AIKAULA ST
Mailing Address - Street 2:
Mailing Address - City:WAIALUA
Mailing Address - State:HI
Mailing Address - Zip Code:96791
Mailing Address - Country:US
Mailing Address - Phone:808-364-4111
Mailing Address - Fax:
Practice Address - Street 1:67-433 AIKAULA ST
Practice Address - Street 2:
Practice Address - City:WAIALUA
Practice Address - State:HI
Practice Address - Zip Code:96791
Practice Address - Country:US
Practice Address - Phone:808-364-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician