Individual
ELEXIS SANBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-1221 KA UKA BLVD, WAIPAHU, HI 96797-6202
(808) 720-7107
Mailing address
87-2061 PAKEKE ST, WAIANAE, HI 96792-3448
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-177190
HI
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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