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Individual

MR. GLENN A KONDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DCSW LCSW CSAC

Contact information

Practice address
688 KINOOLE ST, STE 119B, HILO, HI 96720
(808) 935-5687
(808) 935-8873
Mailing address
PO BOX 10621, HILO, HI 96721-1062
(808) 935-5687
(808) 935-8873

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
90193
HI
1041C0700X
Clinical Social Worker
Primary
LCSW3070
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
A02141262
HI
Enumeration date
10/04/2006
Last updated
05/05/2010
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