Provider Demographics
NPI:1669142881
Name:ASTILL, MELODY (RBT)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:ASTILL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:
Other - Last Name:MOLINA-LABRADOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:94-151 KUPUNA LOOP
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1117
Mailing Address - Country:US
Mailing Address - Phone:808-673-1055
Mailing Address - Fax:
Practice Address - Street 1:615 PIIKOI ST STE 601
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3176
Practice Address - Country:US
Practice Address - Phone:808-591-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-18
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician