Individual
DIANA TAVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
74-5078 KUMAKANI ST, KAILUA KONA, HI 96740-1530
(808) 746-1779
Mailing address
68-1865 PUA MELIA ST UNIT 503, WAIKOLOA, HI 96738-5603
(631) 316-2981
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1203621
HI
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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