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Individual

MRS. WILLY GRACE P BUNGHANOY-DIAMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA, LCSW

Contact information

Practice address
4510 SALT LAKE BLVD, SUITE D-8, HONOLULU, HI 96818-3153
(808) 591-6060
(808) 591-6233
Mailing address
4510 SALT LAKE BLVD, SUITE D-8, HONOLULU, HI 96818-3153
(808) 591-6060
(808) 591-6233

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-12-11848
HI
1041C0700X
Clinical Social Worker
Primary
4821
HI

Other

Enumeration date
06/26/2013
Last updated
05/23/2022
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