Individual
BRIDGET KATHLEEN BASKERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 ALA MOANA BLVD STE 1, HONOLULU, HI 96814-4262
(808) 585-1424
Mailing address
300 WAI NANI WAY APT 911, HONOLULU, HI 96815-3992
(831) 419-9729
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1188702
HI
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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