Individual
GRANT MALEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
612 HAUSTEN ST APT A, HONOLULU, HI 96826-4587
(949) 422-0618
Mailing address
612 HAUSTEN ST APT A, HONOLULU, HI 96826-4587
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-45902
HI
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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