Provider Demographics
NPI:1386469070
Name:AHOLELEI, DAPHNE R (RBT)
Entity type:Individual
Prefix:
First Name:DAPHNE
Middle Name:R
Last Name:AHOLELEI
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:HAUULA
Mailing Address - State:HI
Mailing Address - Zip Code:96717-0047
Mailing Address - Country:US
Mailing Address - Phone:808-753-6123
Mailing Address - Fax:
Practice Address - Street 1:55-607 MOANA ST
Practice Address - Street 2:
Practice Address - City:LAIE
Practice Address - State:HI
Practice Address - Zip Code:96762-1237
Practice Address - Country:US
Practice Address - Phone:808-753-6123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician