Provider Demographics
NPI:1316328156
Name:FRANK, MATHEW EVAN (EDS)
Entity type:Individual
Prefix:MR
First Name:MATHEW
Middle Name:EVAN
Last Name:FRANK
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WARD AVE STE 219B
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4003
Mailing Address - Country:US
Mailing Address - Phone:808-585-1424
Mailing Address - Fax:
Practice Address - Street 1:139 HOOWAIWAI LOOP APT 2606
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-4132
Practice Address - Country:US
Practice Address - Phone:808-276-2417
Practice Address - Fax:808-442-9816
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
HIBA176103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst