Individual
RACHAEL S RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41-611 INOAOLE ST, WAIMANALO, HI 96795-1211
(808) 892-4059
Mailing address
46-415 KAHUHIPA ST APT D, KANEOHE, HI 96744-3520
(270) 350-0907
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-22167
NC
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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