Individual
KEENAN DOUGLAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
94-1221 KA UKA BLVD STE 108, WAIPAHU, HI 96797-6299
(808) 292-7968
Mailing address
455 HUALANI ST, KAILUA, HI 96734-5534
(808) 344-0526
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
16-18268
HI
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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