Individual
JENNIFER LINTAG UPHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 KAHELU AVE STE 110, MILILANI, HI 96789-3913
(808) 625-3000
(808) 625-3006
Mailing address
100 KAHELU AVE STE 112, MILILANI, HI 96789-3913
(808) 625-3000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
3101
TX
103K00000X
Behavior Analyst
Primary
BA-340
HI
Other
Enumeration date
10/24/2019
Last updated
09/25/2021
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