Provider Demographics
NPI:1639602949
Name:LAUPOLA, KIANA
Entity Type:Individual
Prefix:
First Name:KIANA
Middle Name:
Last Name:LAUPOLA
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 1:85-761 FARRINGTON HWY STE 206
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-2463
Mailing Address - Country:US
Mailing Address - Phone:808-347-7655
Mailing Address - Fax:
Practice Address - Street 1:85-761 FARRINGTON HWY STE 206
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2463
Practice Address - Country:US
Practice Address - Phone:808-347-7655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-17-29290106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician