Provider Demographics
NPI:1265948376
Name:ZELENSKIY, ANNA (BCBA)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ZELENSKIY
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 1:87-2243 PAKEKE ST
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-5403
Mailing Address - Country:US
Mailing Address - Phone:917-302-0293
Mailing Address - Fax:808-480-7440
Practice Address - Street 1:87-2243 PAKEKE ST
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-5403
Practice Address - Country:US
Practice Address - Phone:917-302-0293
Practice Address - Fax:808-480-7440
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-27
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIBA-736OtherLBA