Individual
DESIREE MINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4510 SALT LAKE BLVD STE D8, HONOLULU, HI 96818-3172
(808) 486-2804
Mailing address
PO BOX 90, WAIALUA, HI 96791-0090
(808) 450-4312
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1249598
HI
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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