Individual
CARISSA THIBODEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
500 ALA MOANA BLVD STE 7400, HONOLULU, HI 96813-4902
(808) 354-0090
Mailing address
2649 VARSITY PL APT 212, HONOLULU, HI 96826-1640
(808) 793-8773
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB594819
HI
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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