Provider Demographics
NPI:1306525159
Name:CHOW, RICHELYN
Entity type:Individual
Prefix:
First Name:RICHELYN
Middle Name:
Last Name:CHOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1159 KEAHUMOA PKWY UNIT 1807
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-4862
Mailing Address - Country:US
Mailing Address - Phone:808-343-8000
Mailing Address - Fax:
Practice Address - Street 1:91-1159 KEAHUMOA PKWY UNIT 1807
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-4862
Practice Address - Country:US
Practice Address - Phone:808-343-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-23-279708106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician