Individual
PRINCESS MICUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-1221 KA UKA BLVD, WAIPAHU, HI 96797-6202
(808) 773-2792
Mailing address
87-2147 PAKEKE ST, WAIANAE, HI 96792-5402
(808) 271-4873
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-118379
HI
Other
Enumeration date
05/17/2020
Last updated
05/17/2020
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