Individual
DONNA IWALANI COSTALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-450 MOKUOLA ST STE 100, WAIPAHU, HI 96797-3388
(909) 944-2882
Mailing address
94-569 PILIMAI PLACE, UNITED S, WAIPAHU, HI 96797
(808) 469-9532
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-94407
HI
Other
Enumeration date
11/26/2021
Last updated
11/26/2021
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