Individual
THEODORE IRELAND II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
622 HINANO ST, HILO, HI 96720-4427
(808) 238-4771
Mailing address
67 TODD AVE, HILO, HI 96720-4848
(808) 238-4771
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
4012
HI
Other
Enumeration date
08/25/2010
Last updated
02/16/2017
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