Individual
KETSY KAREN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
91-1841 FORT WEAVER RD, EWA BEACH, HI 96706-1909
(808) 681-3500
Mailing address
95-1053 MEANUI ST, MILILANI, HI 96789-4215
(808) 799-9429
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
HI
Other
Enumeration date
08/12/2020
Last updated
09/18/2020
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