Individual
MISS JENNIE L TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
100 KAHELU AVE STE 112, MILILANI, HI 96789-3913
(808) 625-3000
(808) 625-3006
Mailing address
5326 TAMARIND LN, HONOLULU, HI 96818-7083
(517) 899-8632
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-11-8945
CO
103K00000X
Behavior Analyst
Primary
BA-495
HI
103K00000X
Behavior Analyst
—
MI
Other
Enumeration date
12/01/2011
Last updated
12/09/2021
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