Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-15-04461 | HI |
NPI | 1003324930 |
---|---|
Provider Name | Sarah Anne Haseth |
First Address | Kapolei, HI 96707-4227 |
Second Address | Kapolei, HI 96707-4227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2018 |
Last Update Date | 12/01/2018 |