Individual
LISA NALANI BACAREZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 KAMOKILA BLVD STE 206, KAPOLEI, HI 96707-2096
(808) 591-6969
Mailing address
94-337 ANANIA DR APT 9, MILILANI, HI 96789-4500
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-149372
HI
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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