Provider Demographics
NPI:1942087705
Name:KIPILII, BREE
Entity type:Individual
Prefix:
First Name:BREE
Middle Name:
Last Name:KIPILII
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 1:91-1007 AUHOLA ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3969
Mailing Address - Country:US
Mailing Address - Phone:808-497-9275
Mailing Address - Fax:
Practice Address - Street 1:550 KUNEHI ST APT 206
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2069
Practice Address - Country:US
Practice Address - Phone:808-674-6641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-23-297055106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician