Individual
HEATHER WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1-611 INOAOLE ST, WAIMANALO, HI 96795
(808) 892-4059
Mailing address
41-611 INOAOLE ST, WAIMANALO, HI 96795-1211
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
HI
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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