Latisha Ann Balai-Pacheco
Individual provider Active NPI Behavior Analyst · Hilo, HI
NPI 1295433803 · NPPES record last updated Feb 22, 2023
Key facts
- NPI
- 1295433803
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- RBT-21-159608 (HI)
- Practice address
- 121 Haaheo Rd
Hilo, HI 96720-2144 - Phone
- (808) 974-4111
- NPI assigned
- Feb 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-21-159608 | HI | MD | Behavioral Analyst |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | RBT-21-159608 | HI | Yes |
Addresses
Primary practice location
121 Haaheo Rd
Hilo, HI 96720-2144
Mailing address
480 Waianuenue Ave
Hilo, HI 96720-2521
Phone (808) 974-4401
Other providers in Hilo, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.