Individual
TIRESA MAIAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1001 KAMOKILA BLVD STE 206, KAPOLEI, HI 96707-2096
(808) 591-6060
Mailing address
1252 LOKO DR, WAHIAWA, HI 96786-2315
(808) 800-6719
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20-119178
HI
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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