Individual
MRS. MACKEALA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 PALEKAUA ST, HONOLULU, HI 96816-4755
(808) 780-0014
Mailing address
PO BOX 22005, HONOLULU, HI 96823-2005
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
HI
Other
Enumeration date
03/09/2022
Last updated
07/11/2023
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