Individual
MENCHIE CANDA KOSCELEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MEDICAL TECHNOLOGIST
Contact information
Practice address
95-336 KALOAPAU ST APT 162, MILILANI, HI 96789-1215
(808) 554-2205
Mailing address
95-336 KALOAPAU ST APT 162, MILILANI, HI 96789-1215
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
900773473
—
HI
Enumeration date
10/17/2017
Last updated
06/16/2018
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