Individual
DAVID LA SALLE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
94-1221 KA UKA BLVD, WAIPAHU, HI 96797-6202
(808) 773-2692
Mailing address
2140 DOLE ST, HONOLULU, HI 96822-3315
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-105137
HI
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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