Individual
NICOLE KIYO TSUCHIYA IMANAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
91-1841 FORT WEAVER RD, EWA BEACH, HI 96706-1909
(808) 748-3146
Mailing address
721 HAHAIONE ST, HONOLULU, HI 96825-1030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
4342
HI
251S00000X
Community/Behavioral Health Agency
Primary
4342
HI
Other
Enumeration date
01/08/2019
Last updated
12/21/2022
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