Individual
ANGELIQUE VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4510 SALT LAKE BLVD STE C4, HONOLULU, HI 96818-3171
(808) 486-1804
Mailing address
4510 SALT LAKE BLVD STE C4, HONOLULU, HI 96818-3171
(253) 881-9945
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
09/26/2019
Last updated
01/31/2022
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