Individual
HEATHER TESORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41-611 INOAOLE ST, WAIMANALO, HI 96795-1211
(808) 892-4059
Mailing address
1121 ALA NAPUNANI ST APT 1002, HONOLULU, HI 96818-1604
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
16-14349
HI
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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