Individual
ERNESTO FONTANILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
427 ALA MAKANI ST, KAHULUI, HI 96732-3571
(808) 204-2893
Mailing address
350 OE ST, KIHEI, HI 96753-8963
(808) 385-6789
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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