Individual
LUKE STUMFALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2125 KAHEKILI HWY, WAILUKU, HI 96793-9208
(808) 727-5300
Mailing address
223 HALENANI DR, WAILUKU, HI 96793-2404
(818) 231-4213
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H01702009
DRIVER'S LICENSE
HI
Enumeration date
02/21/2022
Last updated
10/05/2022
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