Individual
GAGE HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
55-101 LANIHULI ST, LAIE, HI 96762-2225
(435) 772-1122
Mailing address
55-101 LANIHULI ST, LAIE, HI 96762-2225
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23-256751
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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