Individual
LAURA CORINNE MAAKESTAD SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. A., L.M.H.C.
Contact information
Practice address
84-680 KILI DR, SUITE #803, WAIANAE, HI 96792-1524
(808) 888-9237
Mailing address
84-680 KILI DR, SUITE #803, WAIANAE, HI 96792-1524
(808) 888-9237
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
36
HI
101YM0800X
Mental Health Counselor
LH00006237
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105HI03587
HMSA
HI
Enumeration date
10/24/2006
Last updated
01/05/2012
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