Individual
DESTINY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1611 HULI RD, KILAUEA, HI 96754-5565
(808) 292-7968
Mailing address
PO BOX 375, KILAUEA, HI 96754-0375
(808) 292-7968
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-309457
HI
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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