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Individual

BROOKLYN DOMEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
73 PUUHONU PL STE 100, HILO, HI 96720-2060
(808) 687-0117
Mailing address
73 PUUHONU PL STE 100, HILO, HI 96720-2060
(808) 687-0117

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
HI

Other

Enumeration date
08/08/2025
Last updated
08/08/2025
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