Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | HI |
NPI | 1003401852 |
---|---|
Provider Name | Jeremiah Hudson Webb |
First Address | Kahului, HI 96732-3507 |
Second Address | Kahului, HI 96732-3507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2021 |
Last Update Date | 03/03/2021 |