Individual
JERRELL RALPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
91-1841 FORT WEAVER RD, EWA BEACH, HI 96706-1909
(808) 681-1470
Mailing address
186 HIKINA CT UNIT 102, WAHIAWA, HI 96786-5480
(757) 297-0083
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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