Individual
KHEASHUNTZI LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1390 MILLER ST, HONOLULU, HI 96813-2493
(808) 586-3230
Mailing address
4742 W EKAHI WAY APT D, EWA BEACH, HI 96706-3033
(808) 723-9829
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/23/2021
Last updated
07/23/2021
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