Individual
MARA KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3075 ALA POHA PL APT 904, HONOLULU, HI 96818-1685
(262) 483-6205
Mailing address
3075 ALA POHA PL APT 904, HONOLULU, HI 96818-1685
(262) 483-6205
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002265100
—
HI
Enumeration date
02/25/2016
Last updated
02/25/2016
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