Provider Demographics
NPI:1821463324
Name:GIBO, NIKI ANN KIKU
Entity Type:Individual
Prefix:MS
First Name:NIKI ANN
Middle Name:KIKU
Last Name:GIBO
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 1:161 S WAKEA AVE
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732
Mailing Address - Country:US
Mailing Address - Phone:808-244-7467
Mailing Address - Fax:808-242-5835
Practice Address - Street 1:161 S WAKEA AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732
Practice Address - Country:US
Practice Address - Phone:808-244-7467
Practice Address - Fax:808-242-5835
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst