Individual
MS. KELSEY HEATHER FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
91-2301 OLD FT WEAVER RD, EWA BEACH, HI 96706-3602
(808) 671-8511
(808) 677-2525
Mailing address
1327 KEOLU DR, KAILUA, HI 96734-4113
(360) 961-2047
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
—
—
Other
Enumeration date
11/10/2008
Last updated
11/10/2008
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