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Individual

COLBY LEE MUSGROVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3795 MAPUANA PL, PRINCEVILLE, HI 96722-5344
(808) 292-7968
Mailing address
PO BOX 375, KILAUEA, HI 96754-0375
(808) 292-7968

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-270179
HI

Other

Enumeration date
05/04/2023
Last updated
05/04/2023
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