Organization
ONE STEP UP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFRIE WAGNER CSAC, LMFT (CLINICAL CONSULTANT/BOD)
(808) 221-8994
Entity
Organization
Contact information
Practice address
810 N VINEYARD BLVD, RM 14E, HONOLULU, HI 96817-3590
(808) 841-4444
(808) 841-4444
Mailing address
810 N VINEYARD BLVD, RM 14E, HONOLULU, HI 96817-3590
(808) 841-4444
(808) 841-4444
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
127
HI
Other
Enumeration date
10/08/2010
Last updated
11/19/2010
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