Individual
DANIEL VICTOR DUDLEY PETTIT-LENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 KINOOLE STREET, HILO, HI 96720
(808) 292-3783
Mailing address
83 MAIKAI ST, HILO, HI 96720
(808) 292-3783
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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