Individual
POE SUAAVA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
85-979 MILL ST, WAIANAE, HI 96792-2645
(808) 696-9498
(808) 696-9403
Mailing address
86-226 FARRINGTON HWY, WAIANAE, HI 96792-3128
(808) 696-4211
(808) 696-5516
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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