Individual
DIANE CRISERLEENE MATEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1390 MILLER ST, HONOLULU, HI 96813-2493
(808) 381-8907
Mailing address
94-352 KAHUAHELE ST, WAIPAHU, HI 96797-3465
(808) 551-3992
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R000080140999
—
HI
Enumeration date
04/06/2022
Last updated
09/26/2023
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