Individual
KELLI AKEMI DECOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1390 MILLER ST, HONOLULU, HI 96813-2493
(808) 600-0997
Mailing address
47-330 AHUIMANU RD APT E203, KANEOHE, HI 96744-4820
(808) 600-0997
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
HI
Other
Enumeration date
05/11/2024
Last updated
05/11/2024
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