Individual
JOSEPH MARTIN BACAY DATU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
91-1159 KAMAKANA ST APT 120, EWA BEACH, HI 96706-2023
(808) 721-8386
Mailing address
7002 HAWAII KAI DR APT 1911, HONOLULU, HI 96825-4209
(808) 724-7531
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB981803
HI
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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