Individual
JEROME CRISOSTOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4510 SALT LAKE BLVD STE D8, HONOLULU, HI 96818-3172
(808) 486-9197
Mailing address
4510 SALT LAKE BLVD STE D8, HONOLULU, HI 96818-3172
(808) 486-9197
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/26/2017
Last updated
12/26/2017
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