Individual
BROOKE FETTEROLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
126 AIKAHI LOOP, KAILUA, HI 96734-1642
(808) 490-1668
(808) 369-7106
Mailing address
126 AIKAHI LOOP, KAILUA, HI 96734-1642
(808) 490-1668
(808) 369-7106
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-265043
HI
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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