Individual
MADISON DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 KAPPAA QUARRY PL, #5002, KAILUA, HI 96734
(808) 741-2232
Mailing address
480 S ROGERS RD, OLATHE, KS 66062-1706
(913) 324-3849
(913) 780-3387
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-66446
HI
106S00000X
Behavior Technician
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Other
Enumeration date
09/03/2021
Last updated
07/10/2023
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