Individual
MARYSOL DULDULAO GANOTISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4272 KAILEWA ST, LIHUE, HI 96766-9410
(808) 639-5754
(808) 212-1287
Mailing address
4272 KAILEWA ST, LIHUE, HI 96766-9410
(808) 639-5754
(808) 212-1287
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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