Individual
KIESHA MCLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4359 KUKUI GROVE ST STE 102, LIHUE, HI 96766-2008
(916) 337-4052
Mailing address
191 GRANDVIEW DR, HINESVILLE, GA 31313-2831
(912) 332-7920
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/11/2020
Last updated
05/11/2020
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