Individual
SUSAN LYNNE BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1130 N NIMITZ HWY RM C301, HONOLULU, HI 96817-6501
(808) 535-1775
Mailing address
1130 N NIMITZ HWY RM C301, HONOLULU, HI 96817-6501
(808) 535-1775
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1822
HI
Other
Enumeration date
05/11/2012
Last updated
05/11/2012
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