Individual
JEANETTE TIANA SIMRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 KAMOKILA BLVD STE 210, KAPOLEI, HI 96707-2096
(808) 591-6060
Mailing address
98-135 LIPOA PL APT 101, AIEA, HI 96701-4893
(808) 364-5018
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
07/31/2021
Last updated
07/31/2021
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