Individual
JASON TAKAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
40 KUPUOHI ST STE 206, LAHAINA, HI 96761-2714
(808) 446-4561
Mailing address
871 NIHEU ST, LAHAINA, HI 96761-2154
(808) 281-6119
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-335488
HI
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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