Provider Demographics
NPI:1659156099
Name:FERREIRA, MICAELA DE FATIMA (RBT)
Entity Type:Individual
Prefix:
First Name:MICAELA
Middle Name:DE FATIMA
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E LIPOA ST STE 29
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8148
Mailing Address - Country:US
Mailing Address - Phone:808-793-2005
Mailing Address - Fax:
Practice Address - Street 1:41 E LIPOA ST STE 29
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8148
Practice Address - Country:US
Practice Address - Phone:808-793-2005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician