Individual
REVA WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 KAMOKILA BLVD STE 210, KAPOLEI, HI 96707-2096
(808) 591-6060
Mailing address
4279 INDEPENDENCE LOOP APT F, KAPOLEI, HI 96707-3563
(224) 730-8344
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-295535
HI
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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