Individual
MISS ALEXIS NICOLE MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 ALA MOANA BLVD, HONOLULU, HI 96813-4920
(808) 354-0090
Mailing address
500 ALA MOANA BLVD, HONOLULU, HI 96813-4920
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-67724
HI
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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