Individual
KARLI SHAYE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-450 MOKUOLA ST STE 100, WAIPAHU, HI 96797-3388
(480) 620-9517
Mailing address
2067 PALOLO AVE, HONOLULU, HI 96816-6189
(480) 620-9517
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
BACB610465
HI
106S00000X
Behavior Technician
Primary
RBT-20-143505
HI
106S00000X
Behavior Technician
—
HI
Other
Enumeration date
11/17/2022
Last updated
12/02/2022
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