Individual
MADDISEN DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
200 N VINEYARD BLVD, HONOLULU, HI 96817-3950
(808) 536-1015
Mailing address
2730 SHADELANDS DR BLDG 10, WALNUT CREEK, CA 94598-2538
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
423
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
820185
—
HI
Enumeration date
09/22/2020
Last updated
01/23/2024
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