Individual
MISS BAILEY R GONGOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
771 AMANA ST STE 201, HONOLULU, HI 96814-3238
(808) 294-9728
Mailing address
335 ANAPALAU ST, HONOLULU, HI 96825-2241
(808) 294-9728
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
HI
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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