Individual
JACOB DAVID EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1867 E VINEYARD ST, WAILUKU, HI 96793-1847
(808) 298-0111
Mailing address
1867 E VINEYARD ST, WAILUKU, HI 96793-1847
(808) 298-0111
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT26523101
HI
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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