Individual
LEAH ETSUKO TERAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
74-5078 KUMAKANI ST, KAILUA KONA, HI 96740-1530
(808) 746-1779
Mailing address
PO BOX 820, HOLUALOA, HI 96725-0820
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-220087
HI
Other
Enumeration date
06/25/2022
Last updated
06/25/2022
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