Healthcare Provider Details

I. General information

NPI: 1003729393
Provider Name (Legal Business Name): MYA KEYS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-539 PUAHI ST
WAIPAHU HI
96797-6200
US

IV. Provider business mailing address

952 PROSPECT ST
HONOLULU HI
96822-3418
US

V. Phone/Fax

Practice location:
  • Phone: 808-591-6060
  • Fax:
Mailing address:
  • Phone: 469-451-6993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2853912
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: