Individual
MRS. SERENA MARIE WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
909 KAPA'A QUARRY PL, KAILUA, HI 96734
(808) 741-2232
Mailing address
1782B LITTLER CT, KAILUA, HI 96734-5112
(218) 252-8111
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
G597068562621
MN
Other
Enumeration date
05/13/2019
Last updated
05/13/2019
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