Individual
REBECCA TO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
69 KAUAULA RD, LAHAINA, HI 96761-1150
(808) 392-0530
Mailing address
69 KAUAULA RD, LAHAINA, HI 96761-1150
(808) 392-0530
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/14/2017
Last updated
05/30/2023
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