Individual
BRANDY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-1221 KA UKA BLVD, WAIPAHU, HI 96797-6202
(808) 292-7968
Mailing address
81 KALIKO DR, WAHIAWA, HI 96786-2716
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-96731
HI
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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