Individual
LAURIE L LA MADRID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
94-1042 KA UKA BLVD STE 203, WAIPAHU, HI 96797-6209
(808) 650-2468
Mailing address
94-1042 KA UKA BLVD STE 203, WAIPAHU, HI 96797-6209
(808) 650-2468
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT-455
HI
Other
Enumeration date
09/16/2015
Last updated
12/27/2020
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