Individual
NICOLE TAKAHASHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-450 MOKUOLA ST STE 100, WAIPAHU, HI 96797-3388
(808) 944-2882
Mailing address
PO BOX 1947, PEARL CITY, HI 96782-8947
(808) 754-4592
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
19-81869
HI
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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