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1104443522
LOGAN GONZAGA
HONOLULU, HI
NPI
1104443522
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: HI RBT-20-125822)
Enumeration Date
2020-07-01
Last Update Date
2020-07-01
Business Address
LOGAN GONZAGA
564 SOUTH ST
HONOLULU, HI 96813-5013
Phone number: 808-591-1173
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Mailing Address
LOGAN GONZAGA
94-524 PALAI ST
WAIPAHU, HI 96797-1269
Phone number:
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