Individual
COLLEEN JO STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4754B E EKAHI WAY # B, EWA BEACH, HI 96706-3004
(907) 354-2945
Mailing address
4754 E EKAHI WAY APT B, EWA BEACH, HI 96706-3028
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-427043
HI
246ZS0410X
Surgical Technologist
100256574
AK
Other
Enumeration date
02/21/2024
Last updated
04/16/2025
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