Individual
LYZA ANGELICA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 ALA MOANA BLVD STE 400, HONOLULU, HI 96813-4920
(808) 472-6522
Mailing address
30 KOELE WAY APT C, WAHIAWA, HI 96786-5729
(808) 777-0746
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/07/2020
Last updated
09/09/2020
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