Individual
KEN O BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
203 KAPAA QUARRY PL, #5002, KAILUA, HI 96734
(808) 247-2973
Mailing address
203 KAPAA QUARRY PL, 5002, KAILUA, HI 96734
(808) 247-2973
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
HI
167G00000X
Licensed Psychiatric Technician
PT37597
CA
Other
Enumeration date
06/19/2023
Last updated
03/27/2025
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