Provider Demographics
NPI:1588941850
Name:TATEKAWA, LAWRENCE JIN (BCBA)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:JIN
Last Name:TATEKAWA
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-732 MAIAKU ST
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-2816
Mailing Address - Country:US
Mailing Address - Phone:808-294-7752
Mailing Address - Fax:
Practice Address - Street 1:95-732 MAIAKU ST
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-2816
Practice Address - Country:US
Practice Address - Phone:808-294-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst