Individual
MISS IVANA MICHELE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 AE ST APT H106, KAPOLEI, HI 96707-4579
(808) 375-9846
Mailing address
1025 AE ST APT H106, KAPOLEI, HI 96707-4579
(808) 375-9846
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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