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General NPI Number Information
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NPI Number | 1952834814
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Entity Type | Individual
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Provider Name | AMBER DESROCHES
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Gender | Female
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 1390 MILLER ST
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City | HONOLULU
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State | HI
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Zip | 96813-2493
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Country | US
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Telephone | 808-427-9257
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Fax |
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Provider Business Mailing Address
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Address Line | 59-533 MAKANA RD
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City | HALEIWA
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State | HI
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Zip | 96712-9640
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Country | US
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Telephone | 808-343-5635
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | HI
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