Individual
KIMBERLY ERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
92-1232 PALAHIA ST APT AA101, KAPOLEI, HI 96707-2345
(808) 218-2544
Mailing address
92-1232 PALAHIA ST APT AA101, KAPOLEI, HI 96707-2345
(808) 218-2544
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-93154
HI
Other
Enumeration date
12/13/2019
Last updated
03/14/2023
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