Individual
MICHELLE ALYSSA TELLEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2122 LIME ST APT 404, HONOLULU, HI 96826-4177
(760) 556-7513
Mailing address
2122 LIME ST APT 404, HONOLULU, HI 96826-4177
(760) 556-7513
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-79102
HI
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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