Most Relevant Information
Provider Data
| NPI Number: | 1003306341 |
| Provider Name: | CRYSTAL PENA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/11/2018 |
| Last Updated: | 05/11/2018 |
Provider Practice Location
3748 KUMUKOA PL
HONOLULU
HI
968221106
Practice Location Phone/Fax
| Phone: | 8089884713 |
| Fax: |
Provider Mailing Location
4510 SALT LAKE BLVD STE D8
HONOLULU
HI
968183172
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |