Individual
MS. TYRA RENEE DU BOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
555 FRASER AVE, LANAI CITY, HI 96763-1774
(808) 649-0869
Mailing address
PO BOX 631774, LANAI CITY, HI 96763-1774
(808) 649-0869
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
HI
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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