Provider Demographics
NPI:1396981288
Name:FAYE, DIANE (M EDUCATION)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:FAYE
Suffix:
Gender:F
Credentials:M EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 KIPUKA ST
Mailing Address - Street 2:
Mailing Address - City:KOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96756-9738
Mailing Address - Country:US
Mailing Address - Phone:401-252-9163
Mailing Address - Fax:
Practice Address - Street 1:2460 KIPUKA ST
Practice Address - Street 2:
Practice Address - City:KOLOA
Practice Address - State:HI
Practice Address - Zip Code:96756-9738
Practice Address - Country:US
Practice Address - Phone:401-252-9163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI315103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1396981288OtherUBH
RI1104847946OtherTHE PROVIDENCE CENTER NPI