Provider Demographics
NPI:1215292792
Name:DE CRINIS, LORI G (BCBA, LBA99)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:G
Last Name:DE CRINIS
Suffix:
Gender:F
Credentials:BCBA, LBA99
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:G
Other - Last Name:BABBITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, LBA99
Mailing Address - Street 1:161 S WAKEA AVE
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-1343
Mailing Address - Country:US
Mailing Address - Phone:808-244-7467
Mailing Address - Fax:760-832-6761
Practice Address - Street 1:161 S WAKEA AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1343
Practice Address - Country:US
Practice Address - Phone:808-244-7467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI99103K00000X
CA1-09-5815103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty