Individual
MR. MICHAEL FREDELUCES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4510 SALT LAKE BLVD STE D8, HONOLULU, HI 96818-3172
(808) 486-1804
(808) 486-9199
Mailing address
4510 SALT LAKE BLVD STE D8, HONOLULU, HI 96818-3172
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
16-17068
HI
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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