Individual
RANDY BRYAN FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
622 HINANO ST, HILO, HI 96720-4427
(808) 589-1829
Mailing address
PO BOX 2018, VOLCANO, HI 96785-2018
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/12/2019
Last updated
04/12/2019
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