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Individual

MR. JAY CASUPANG ALCISTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
459 PATTERSON RD # 116, HONOLULU, HI 96819-1522
(808) 433-0778
(808) 433-0395
Mailing address
459 PATTERSON RD # 116, HONOLULU, HI 96819-1522
(808) 433-0778
(808) 433-0395

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3750
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3750
LCSW
HI
Enumeration date
02/25/2008
Last updated
07/19/2013
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