Individual
KELLY DEACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
99-950 IWAENA ST FL 2, AIEA, HI 96701-5645
(808) 277-7736
Mailing address
99-950 IWAENA ST FL 2, AIEA, HI 96701-5645
(808) 277-7736
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-12-5019
HI
Other
Enumeration date
05/13/2013
Last updated
05/13/2013
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