Individual
MARK THOMAS VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 861684, WAHIAWA, HI 96786-8563
(808) 220-7042
Mailing address
PO BOX 752123, HOUSTON, TX 77275-2123
(312) 476-9064
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2523
HI
1041C0700X
Clinical Social Worker
12858-C
NV
1041C0700X
Clinical Social Worker
Primary
5291
HI
Other
Enumeration date
08/08/2023
Last updated
05/04/2026
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