Individual
MRS. BAILEY JANE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41-611 INOAOLE ST, WAIMANALO, HI 96795-1211
(808) 892-4059
(808) 260-4391
Mailing address
41-611 INOAOLE ST, WAIMANALO, HI 96795-1211
(808) 892-4059
(808) 260-4391
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-63053
HI
Other
Enumeration date
08/13/2018
Last updated
08/13/2018
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