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Individual

MR. JETHRO TANGONAN MACARAEG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2527 WAOLANI AVE, HONOLULU, HI 96817-1361
(808) 480-4198
Mailing address
PO BOX 235192, HONOLULU, HI 96823-3503
(808) 258-7438

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
3114
HI
1041C0700X
Clinical Social Worker
Primary
LCSW-5268
HI

Other

Enumeration date
10/23/2023
Last updated
02/09/2025
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