Individual
MAIYA STEPHANY MIYOKO EZAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1524 PENSACOLA ST APT 318, HONOLULU, HI 96822-3874
(808) 312-9307
Mailing address
95-068 KAULUA ST, MILILANI, HI 96789-1510
(808) 673-0595
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-334706
HI
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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