Individual
NANI WADDOUPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, MA, NCC
Contact information
Practice address
45-3497 KOA RD, HONOKAA, HI 96727
(503) 784-6214
Mailing address
PO BOX 174, HONOKAA, HI 96727-0174
(503) 784-6214
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C3879
OR
Other
Enumeration date
01/20/2014
Last updated
06/09/2021
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