Individual
MARICEL BALLARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
94-877 LUMIIKI ST, WAIPAHU, HI 96797-3933
(808) 729-3216
(808) 200-5552
Mailing address
94-877 LUMIIKI ST, WAIPAHU, HI 96797-3933
(808) 729-3216
(808) 200-5552
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
HCBS 09-2434
HI
Other
Enumeration date
08/27/2014
Last updated
10/27/2016
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