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Individual

JASON BUMANGLAG REDICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
91-2128 OLD FT WEAVER RD, EWA BEACH, HI 96706-1911
(808) 589-1829
Mailing address
615 PIIKOI ST, SUITE 203, HONOLULU, HI 96814
(808) 589-1829
(808) 589-2610

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT-815-0
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0002276625
HI
Enumeration date
09/08/2017
Last updated
01/19/2023
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