Individual
JESSICA SALIBO DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 LAELAE ST, WAILUKU, HI 96793-9482
(808) 244-9819
Mailing address
1016 LAELAE ST, WAILUKU, HI 96793-9482
(808) 244-9819
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
HI020901397
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59755201
—
HI
Enumeration date
04/09/2009
Last updated
04/09/2009
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