Individual
MR. EZRA IMIPONO SHERIDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
56-660 KAMEHAMEHA HWY, KAHUKU, HI 96731-2210
(877) 393-7555
Mailing address
59-448 KAMEHAMEHA HWY, HALEIWA, HI 96712-9624
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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