Individual
MICHELLE THORSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
247 BEACH WALK, HONOLULU, HI 96815-1995
(312) 560-8793
Mailing address
247 BEACH WALK, 203, HONOLULU, HI 96815-1995
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-16835
TRICARE
—
Enumeration date
09/27/2017
Last updated
06/11/2019
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