Provider Demographics
NPI:1710763230
Name:HUTCHINSON, BRIENT KEALOHA AVISO (BA)
Entity Type:Individual
Prefix:MR
First Name:BRIENT KEALOHA
Middle Name:AVISO
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 MILLER ST STE 310
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2403
Mailing Address - Country:US
Mailing Address - Phone:180-858-7408
Mailing Address - Fax:
Practice Address - Street 1:1390 MILLER ST STE 310
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2403
Practice Address - Country:US
Practice Address - Phone:180-858-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician