Individual
ALYSSA ROSE SKINNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
74-5078 KUMAKANI ST # 589, KAILUA KONA, HI 96740-1530
(520) 248-0511
Mailing address
75-214 ALA ONAONA ST, KAILUA KONA, HI 96740-3803
(520) 248-0511
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-359732
HI
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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