Individual
AISHA TIERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
95-732 MAIAKU ST, MILILANI, HI 96789-2816
(808) 321-8105
(808) 623-6937
Mailing address
91-206 LOULULELO PL, KAPOLEI, HI 96707-3108
(808) 294-7543
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-92036
HI
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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