Individual
MYKAYLA JEAN INNERST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BEHAVIOR TECHNICIAN
Contact information
Practice address
1330 ALA MOANA BLVD STE 1, HONOLULU, HI 96814-4262
(808) 585-1424
Mailing address
91-1001 KEAUNUI DR UNIT 362, EWA BEACH, HI 96706-6345
(602) 403-4317
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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