Provider Demographics
NPI:1194502195
Name:KEAHI, TAIMANE L
Entity type:Individual
Prefix:
First Name:TAIMANE
Middle Name:L
Last Name:KEAHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 NAMILIMILI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-1324
Mailing Address - Country:US
Mailing Address - Phone:808-979-6232
Mailing Address - Fax:
Practice Address - Street 1:223 NAMILIMILI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-1324
Practice Address - Country:US
Practice Address - Phone:808-979-6232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst