Individual
MICHELLE TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-1221 KA UKA BLVD, WAIPAHU, HI 96797-6202
(808) 773-2792
Mailing address
1189 WAIMANU ST APT 1109, HONOLULU, HI 96814-4109
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-137436
HI
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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