Provider Demographics
NPI:1063120137
Name:COLEMAN, KALEONANI SHARLOT (RBT)
Entity type:Individual
Prefix:MS
First Name:KALEONANI
Middle Name:SHARLOT
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MS
Other - First Name:KALEONANI
Other - Middle Name:SHARLOT
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JD
Mailing Address - Street 1:777 PAANI ST APT 504
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-4227
Mailing Address - Country:US
Mailing Address - Phone:808-386-7552
Mailing Address - Fax:
Practice Address - Street 1:777 PAANI ST APT 504
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-4227
Practice Address - Country:US
Practice Address - Phone:808-386-7552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty