Provider Demographics
NPI:1699183178
Name:THOMPSON, SHAYLA MAKANOE MIE
Entity Type:Individual
Prefix:MS
First Name:SHAYLA
Middle Name:MAKANOE MIE
Last Name:THOMPSON
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 1:4111 WAHA RD
Mailing Address - Street 2:
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-9409
Mailing Address - Country:US
Mailing Address - Phone:808-634-2224
Mailing Address - Fax:
Practice Address - Street 1:4111 WAHA RD
Practice Address - Street 2:
Practice Address - City:KALAHEO
Practice Address - State:HI
Practice Address - Zip Code:96741-9409
Practice Address - Country:US
Practice Address - Phone:808-634-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst