Individual
JUAN WAHL BANIS VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
92-099 LEIPAPA WAY, KAPOLEI, HI 96707-1343
(808) 725-9275
Mailing address
PO BOX 892718, MILILANI, HI 96789-8332
(808) 725-9275
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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