Individual
JAELENE KANANI LASTIMADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
17943 KUKUI CAMP RD, MT VIEW, HI 96771
(808) 333-8193
Mailing address
16-566 KEAAU PAHOA RD STE 188, KEAAU, HI 96749-8137
(808) 333-8193
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-84668
HI
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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