Provider Demographics
NPI:1699441154
Name:GO, LESTER (RBT)
Entity type:Individual
Prefix:MR
First Name:LESTER
Middle Name:
Last Name:GO
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3868 ROUND TOP DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-5017
Mailing Address - Country:US
Mailing Address - Phone:619-549-7233
Mailing Address - Fax:
Practice Address - Street 1:3868 ROUND TOP DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-5017
Practice Address - Country:US
Practice Address - Phone:619-549-7233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-21-170065106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician