Lucas James Bauer

Individual provider Active NPI Behavior Technician · Lahaina, HI

NPI 1366064693 · NPPES record last updated May 8, 2020

Key facts

NPI
1366064693
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-20-117338 (HI)
Practice address
553 Wainee St
Lahaina, HI 96761-1109
Phone
(808) 667-0422
NPI assigned
May 8, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-20-117338HIMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-20-117338 HI Yes

Addresses

Primary practice location

553 Wainee St
Lahaina, HI 96761-1109

Mailing address

PO Box 12704
Lahaina, HI 96761-7704
Phone (360) 556-3542

Other providers in Lahaina, HI

All providers in Lahaina, HI · Behavior Technician in Hawaii

Sources for this page

Verify at the official NPI Registry.