Individual
BRENDA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4510 SALT LAKE BLVD STE D8, HONOLULU, HI 96818-3172
(808) 204-2893
Mailing address
44-375 KANEOHE BAY DR, KANEOHE, HI 96744-2664
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-427938
HI
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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