Individual
LAILENE EVELYN VISORIA AGBISIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4510 SALT LAKE BLVD, HONOLULU, HI 96818-3153
(808) 486-1804
Mailing address
94-1072 LUMIAINA ST, WAIPAHU, HI 96797-3914
(808) 690-4619
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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