Provider Demographics
NPI:1881103919
Name:MAILO, TESTINY K J
Entity type:Individual
Prefix:MRS
First Name:TESTINY
Middle Name:K J
Last Name:MAILO
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 1:1046 EHOEHO AVE APT 326
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-1244
Mailing Address - Country:US
Mailing Address - Phone:808-772-6514
Mailing Address - Fax:
Practice Address - Street 1:1046 EHO EHO AVENUE
Practice Address - Street 2:#326
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786
Practice Address - Country:US
Practice Address - Phone:808-772-6514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst