Provider Demographics
NPI:1295494367
Name:ANCHETA, BETHANY M
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:M
Last Name:ANCHETA
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 1:1895 HALEUKANA ST
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-9072
Mailing Address - Country:US
Mailing Address - Phone:808-346-6690
Mailing Address - Fax:888-461-0904
Practice Address - Street 1:1895 HALEUKANA ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-9072
Practice Address - Country:US
Practice Address - Phone:808-346-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst