Individual
SHANNON BOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
250 E LIPOA ST, KIHEI, HI 96753-8125
(808) 875-6818
Mailing address
1493 W KUIAHA RD, HAIKU, HI 96708-5525
(804) 397-0687
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-309664
HI
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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