Individual
NICOLE MARIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3175 ELUA ST STE B, LIHUE, HI 96766-1203
(808) 246-4808
(808) 246-4809
Mailing address
5208 WILI RD, KAPAA, HI 96746-2059
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-99474
HI
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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