Individual
THOMAS GAUSEPOHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
4510 SALT LAKE BLVD STE D8, HONOLULU, HI 96818-3172
(808) 486-1804
Mailing address
6382B OPAEKAA RD, KAPAA, HI 96746-9443
(808) 494-7738
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-31333
HI
Other
Enumeration date
07/15/2018
Last updated
07/15/2018
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