Provider Demographics
NPI:1841055944
Name:KAHULAMU, CODY LAPAELA (RBT LICENSE)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:LAPAELA
Last Name:KAHULAMU
Suffix:
Gender:M
Credentials:RBT LICENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78-227 KAHALUU RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2415
Mailing Address - Country:US
Mailing Address - Phone:808-333-0572
Mailing Address - Fax:
Practice Address - Street 1:75-5591 PALANI RD STE 204
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-3632
Practice Address - Country:US
Practice Address - Phone:808-556-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-23-305701106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty