Provider Demographics
NPI:1952974867
Name:RANMUTHU, MADHUKA PIYUMALI (BCBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:MADHUKA
Middle Name:PIYUMALI
Last Name:RANMUTHU
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 993
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-0993
Mailing Address - Country:US
Mailing Address - Phone:805-795-0621
Mailing Address - Fax:
Practice Address - Street 1:3-3122 KUHIO HWY STE A15
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1157
Practice Address - Country:US
Practice Address - Phone:808-246-9102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBA-554103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst