Individual
LAURA FAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
94-1021 WAIPAHU ST STE 202, WAIPAHU, HI 96797-3664
(808) 782-5379
Mailing address
92-1521 ALIINUI DR # 13A, KAPOLEI, HI 96707-2233
(808) 782-5379
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC 258
HI
Other
Enumeration date
08/17/2011
Last updated
08/17/2011
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