Provider Demographics
NPI:1306269352
Name:JANICKI, BRYANT KALANI LANIKUAKAA (MSW)
Entity type:Individual
Prefix:MR
First Name:BRYANT
Middle Name:KALANI LANIKUAKAA
Last Name:JANICKI
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1029 MAULIHIWA ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2915
Mailing Address - Country:US
Mailing Address - Phone:808-386-7703
Mailing Address - Fax:
Practice Address - Street 1:615 PIIKOI ST
Practice Address - Street 2:SUITE 203
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3116
Practice Address - Country:US
Practice Address - Phone:808-589-2610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst