Individual
CORY NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 KAMOKILA BLVD, KAPOLEI, HI 96707-2014
(808) 778-6797
Mailing address
PO BOX 970010, WAIPAHU, HI 96797-0010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC-348
HI
Other
Enumeration date
11/26/2014
Last updated
11/26/2014
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