Individual
BRIONNA GAIL LEE BUCKHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-450 MOKUOLA ST STE 100, WAIPAHU, HI 96797-3388
(808) 944-2882
Mailing address
6047 WOOTEN ST, WAHIAWA, HI 96786-7553
(540) 560-4050
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-103317
HI
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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