Individual
DR. JAMAL FULANI WASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
76-6225 KUAKINI HWY, HILLSIDE PLAZA SUITE B105, KAILUA KONA, HI 96740-3211
(808) 883-0922
Mailing address
68-1774 LAIE ST, WAIKOLOA, HI 96738-5125
(808) 883-0922
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC 9
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000596536
HMSA-QUEST
HI
Enumeration date
11/13/2006
Last updated
07/08/2007
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