Provider Demographics
NPI:1629493853
Name:KYEWICH-KANEHOLANI, AMELIA (BCABA)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:KYEWICH-KANEHOLANI
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:
Other - Last Name:KYEWICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCABA
Mailing Address - Street 1:7108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7160 AINA PONO ST
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-8306
Practice Address - Country:US
Practice Address - Phone:808-634-3834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician