Individual
MARY BERNARDO AGUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-450 MOKUOLA ST STE 100, WAIPAHU, HI 96797-3388
(800) 892-2900
Mailing address
99-639 HALAWA DR APT A, AIEA, HI 96701-3164
(808) 256-2098
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-127363
HI
Other
Enumeration date
06/17/2022
Last updated
06/17/2022
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