Individual
JEFF MELLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 KANEOHE BAY DR UNIT 211212, KAILUA, HI 96734-1727
(808) 388-1683
(808) 517-3517
Mailing address
25 KANEOHE BAY DR UNIT 211212, KAILUA, HI 96734-1727
(808) 388-1683
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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