Individual
GEORGIA BLAZE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 ALA MOANA BLVD STE 1, HONOLULU, HI 96814-4262
(808) 585-1424
Mailing address
444 LUNALILO HOME RD APT 118, HONOLULU, HI 96825-1707
(310) 920-6643
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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