Individual
MRS. WIEBKE DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LMT
Contact information
Practice address
3660 BALDWIN AVE, MAKAWAO, HI 96768-7500
(808) 250-3020
Mailing address
PO BOX 626, MAKAWAO, HI 96768-0626
(808) 250-3020
(808) 244-5557
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MAT-5497
HI
305R00000X
Preferred Provider Organization
Primary
MAT-5497
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1039824
ASH PROVIDER
HI
Enumeration date
11/10/2006
Last updated
09/11/2025
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