Provider Demographics
NPI:1164240214
Name:EBEL, LILIANA MAE ABIGAIL
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:MAE ABIGAIL
Last Name:EBEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84-719 HANALEI ST
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-1952
Mailing Address - Country:US
Mailing Address - Phone:808-724-5451
Mailing Address - Fax:
Practice Address - Street 1:84-719 HANALEI ST
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-1952
Practice Address - Country:US
Practice Address - Phone:808-724-5451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBACB1168052106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst