Provider Information for 1063715944
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KAREN C TAN LCSW
Sex: Female
NPI: 1063715944
Last Updated: 2010-12-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1063715944 | ||||||||
| Enumeration Date | 2010-12-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 91-1841 FORT WEAVER RD EWA BEACH, HI 96706-1909 United States Phone: 808-681-3500 | Fax:808-681-1486 | ||||||||
| Primary Practice Address | 91-1841 FORT WEAVER RD EWA BEACH, HI 96706-1909 United States Phone: 808-681-3500 | Fax:808-681-1486 | ||||||||
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