Individual
MR. TRINITY MICHAEL HALL I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12760 W 87TH STREET PKWY STE 100, LENEXA, KS 66215-2878
(667) 444-9002
Mailing address
19217 36TH AVE W STE 210, LYNNWOOD, WA 98036-5751
(657) 444-9002
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-95553
KS
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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