Individual
TANYA WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 KAMOKILA BLVD # S210, KAPOLEI, HI 96707-2014
(808) 591-6060
Mailing address
1970 HANALIMA ST APT S204, LIHUE, HI 96766-8940
(910) 580-9179
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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