Provider Demographics
NPI:1265130074
Name:MOYER, LUKE
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:MOYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 KAPAA QUARRY PL
Mailing Address - Street 2:#5002
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734
Mailing Address - Country:US
Mailing Address - Phone:808-741-2232
Mailing Address - Fax:
Practice Address - Street 1:203 KAPAA QUARRY PL
Practice Address - Street 2:#5002
Practice Address - City:KAILUA
Practice Address - State:HAWAII
Practice Address - Zip Code:96734
Practice Address - Country:UM
Practice Address - Phone:808-741-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBACB875560106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIBACB875560OtherBEHAVIORAL ANALYSIS CERTIFICATION BOARD