Individual
AMANDA RENEEE WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
85-761 FARRINGTON HWY STE 206, WAIANAE, HI 96792-2463
(808) 888-2377
Mailing address
85-761 FARRINGTON HWY STE 206, WAIANAE, HI 96792-2463
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-42043
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-17-42043
REGISTERED BEHAVIOR TECHNICIAN
—
Enumeration date
10/13/2017
Last updated
10/13/2017
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