Individual
TIARA RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1895 HALEUKANA ST, LIHUE, HI 96766-9072
(808) 639-5896
Mailing address
4151 MOMI ST, KILAUEA, HI 96754-5312
(808) 639-5896
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT23-279463
HI
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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