Individual
FAEENA S MARTUSHOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2131 LILIKOI RD, HAIKU, HI 96708-5046
(808) 359-4762
Mailing address
11 ALEA PL, MAKAWAO, HI 96768-8703
(808) 500-2886
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-216844
HI
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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