| NPI | 1205216959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANELLE S MEDEIROS Member Manager 808-387-3922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-06-08 |