Provider Demographics
NPI:1811354756
Name:AVILES, TERI (RBT)
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:
Last Name:AVILES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 ALOHI PL
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8707
Mailing Address - Country:US
Mailing Address - Phone:808-495-6470
Mailing Address - Fax:
Practice Address - Street 1:185 ALOHI PL
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8707
Practice Address - Country:US
Practice Address - Phone:808-495-6470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other