Individual
TREVOR MICHAEL SHADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1050 QUEEN ST, HONOLULU, HI 96814-4130
(563) 221-3610
Mailing address
500 ALA MOANA BLVD, #7-400, HONOLULU, HI 96813
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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