Randy Bryan Fonseca

NPI #1780147074 in Hilo, Hawaii

Provider Information

NPI Number: 1780147074
Entity Type: Individual
Name: Randy Bryan Fonseca
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Enumeration Date: Apr 12, 2019
Last Updated: Apr 12, 2019

Practice Location

Address: 622 HINANO ST
City: Hilo
State: Hawaii
ZIP Code: 96720-4427
Phone: (808) 589-1829

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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