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Individual

KAITLYN CALLAIS STAFFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW OR LICSW

Contact information

Practice address
41-038 WAILEA ST STE C, WAIMANALO, HI 96795-1671
(808) 518-4976
Mailing address
41-038 WAILEA ST STE C, WAIMANALO, HI 96795-1671
(808) 518-4976

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
3858C
AL
1041C0700X
Clinical Social Worker
Primary
LCSW4261
HI
1041C0700X
Clinical Social Worker
SW13674
FL

Other

Enumeration date
10/18/2016
Last updated
12/07/2017
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