Individual
BRYAN SPARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
94-1221 KA UKA BLVD., UNIT 108, #167, WAIPAHU, HI 96797
(808) 292-7968
Mailing address
94-1221 KA UKA BLVD., UNIT 108, #167, WAIPAHU, HI 96797
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-19158
HI
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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