Individual
MELISSA DE VICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
65-1279 KAWAIHAE ROAD, SUITE 201, KAMUELA, HI 96743
(808) 313-0593
Mailing address
PO BOX 6844, KAMUELA, HI 96743-6844
(808) 443-7265
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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