Jordan S Conley

Individual provider Active NPI Behavior Technician · Waimanalo, HI

NPI 1083249031 · NPPES record last updated Mar 10, 2020

Key facts

NPI
1083249031
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
41-611 Inoaole St
Waimanalo, HI 96795-1211
Phone
(808) 492-2213
NPI assigned
Mar 10, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

41-611 Inoaole St
Waimanalo, HI 96795-1211

Mailing address

2752 Kahoaloha LN Apt 307
Honolulu, HI 96826-3319
Phone (808) 492-2213

Other providers in Waimanalo, HI

All providers in Waimanalo, HI · Behavior Technician in Hawaii

Sources for this page

Verify at the official NPI Registry.