Individual
GEOFFREY JORDAN TOSHIYUKI MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
710 PALEKAUA ST, HONOLULU, HI 96816-4755
(808) 780-0014
Mailing address
1671 HOOHALIA ST, PEARL CITY, HI 96782-1642
(808) 223-0605
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-136544
HI
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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