Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-21-11807 | HI |
N | 106S00000X | Behavior Technician |
NPI | 1114579778 |
---|---|
Provider Name | Linda Marie Konvit |
First Address | Kahului, HI 96732-3533 |
Second Address | Kahului, HI 96732-3507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2019 |
Last Update Date | 29/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
820185 | (05) | HI |