Provider Demographics
NPI:1992045991
Name:REYNA, LIZABETH ANNE (BCBA)
Entity Type:Individual
Prefix:
First Name:LIZABETH
Middle Name:ANNE
Last Name:REYNA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-7151 ELELE ST APT 1404
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-3389
Mailing Address - Country:US
Mailing Address - Phone:413-478-7018
Mailing Address - Fax:808-888-2029
Practice Address - Street 1:92-1126 OLANI ST APT 1
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4227
Practice Address - Country:US
Practice Address - Phone:714-210-9411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst