Individual
JAELYNN K MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 KAMOKILA BLVD STE 206, KAPOLEI, HI 96707-2096
(808) 591-6060
Mailing address
1001 KAMOKILA BLVD STE 206, KAPOLEI, HI 96707-2096
(808) 591-6060
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-344802
HI
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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