Provider Demographics
NPI:1053171900
Name:NIOTTA, KIRA
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:NIOTTA
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 1:92-964 MAKAKILO DR APT 47
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1370
Mailing Address - Country:US
Mailing Address - Phone:808-291-6573
Mailing Address - Fax:
Practice Address - Street 1:92-964 MAKAKILO DR APT 47
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1370
Practice Address - Country:US
Practice Address - Phone:808-291-6573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician