Individual
MS. GRACE GONZAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
53-356 KAMEHAMEHA HWY, HAUULA, HI 96717-9731
(808) 692-3657
Mailing address
PO BOX 712, HAUULA, HI 96717-0712
(808) 692-3657
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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