Individual
MR. MICHAEL A DATTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1090 E KUIAHA RD, HAIKU, HI 96708-5535
(808) 707-7219
(808) 649-2229
Mailing address
PO BOX 791976, PAIA, HI 96779-1976
(808) 707-7219
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3420
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3420
STATE OF HAWAII LICENSE
HI
Enumeration date
07/31/2006
Last updated
06/10/2023
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