Individual
DR. LISA BETH PONICHTERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LMFT, CSAC
Contact information
Practice address
200 IKE DR, MAKAWAO, HI 96768-9718
(808) 877-7117
Mailing address
388 ANO ST, KAHULUI, HI 96732-3311
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
221
HI
Other
Enumeration date
08/01/2009
Last updated
05/19/2014
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