Individual
CRYSTAL PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3748 KUMUKOA PL, HONOLULU, HI 96822-1106
(808) 988-4713
Mailing address
4510 SALT LAKE BLVD STE D8, HONOLULU, HI 96818-3172
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
HI
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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