Individual
ETHAN MATTHEW GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
564 SOUTH ST, HONOLULU, HI 96813-5013
(808) 591-1173
Mailing address
1653 ALA AMOAMO ST, HONOLULU, HI 96819-1712
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB927957
HI
Other
Enumeration date
05/22/2023
Last updated
06/02/2023
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