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Individual

KENDRICK NOEL SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
94-450 MOKUOLA ST, WAIPAHU, HI 96797-3388
(808) 944-2882
Mailing address
94-450 MOKUOLA STREET, WAIPAHU, HI 96797-1270
(808) 944-2882

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
517569
HI
106S00000X
Behavior Technician
Primary
RBT-19-95448
HI
106S00000X
Behavior Technician

Other

Enumeration date
08/08/2019
Last updated
12/02/2022
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