Individual
MIA MANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28-131 HONOMU ROAD, HONOMU, HI 96728
(808) 763-6096
Mailing address
PO BOX 152, HONOMU, HI 96728-0152
(808) 763-6096
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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