Individual
LUAN BLUE DOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1390 MILLER ST, HONOLULU, HI 96813-2493
(808) 264-6066
Mailing address
1390 MILLER ST, HONOLULU, HI 96813-2493
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
106S00000X
HI
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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