Individual
BRANDON CINCO BANUELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1330 ALA MOANA BLVD STE 1, HONOLULU, HI 96814-4262
(808) 585-1424
Mailing address
1330 ALA MOANA BLVD STE 1, HONOLULU, HI 96814-4262
(808) 585-1424
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB657795
HI
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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