Individual
MEGHAN WALLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
357 HUKU LII PL, SUITE B-201, KIHEI, HI 96753-7051
(808) 371-9517
Mailing address
PO BOX 532374, KIHEI, HI 96753-2374
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2160
HI
1041C0700X
Clinical Social Worker
Primary
4094
HI
Other
Enumeration date
07/23/2015
Last updated
04/25/2017
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