Individual
KEKUULANI IRENE HAAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
553 WAINEE ST, LAHAINA, HI 96761-1109
(808) 446-4561
Mailing address
553 WAINEE ST, LAHAINA, HI 96761-1109
(808) 446-4561
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-215593
HI
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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