Individual
MRS. AMANDA JEAN HAACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
564 SOUTH ST, HONOLULU, HI 96813-5013
(808) 591-1173
(808) 591-1174
Mailing address
564 SOUTH ST, HONOLULU, HI 96813-5013
(808) 591-1173
(808) 591-1174
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-36200
HI
Other
Enumeration date
06/30/2017
Last updated
07/21/2022
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