Individual
JACINTA J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-1221 KA UKA BLVD STE 108, WAIPAHU, HI 96797-6299
(808) 292-7968
Mailing address
3206 AHINAHINA PL, HONOLULU, HI 96816-6217
(434) 258-1069
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-47835
HI
Other
Enumeration date
02/13/2018
Last updated
02/13/2018
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