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Individual

SHEREE D REVILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MFT, CSAC, CADC

Contact information

Practice address
354 ULUNIU ST, SUITE 412, KAILUA, HI 96734-2528
(808) 284-4104
Mailing address
1600 KAPIOLANI BLVD, SUITE 1306, HONOLULU, HI 96814-3801
(808) 284-4104

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1434-09
HI
106H00000X
Marriage & Family Therapist
Primary
253
HI

Other

Enumeration date
08/18/2010
Last updated
07/07/2012
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