Provider Information for 1174082812
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NE'E IMUA COUNSELING LLC
Organization Subpart: NO
NPI: 1174082812
Last Updated: 2020-01-12
Certification Date: 2020-01-12
Certification Date: 2020-01-12
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1174082812 | ||||||||
| Enumeration Date | 2019-03-12 | ||||||||
| NPI Type | NPI-2 Organization | ||||||||
| Status | Active | ||||||||
| Authorized Official Information | Name: DANIELLE GRACE Title: LMFT Phone: 8083891027 | ||||||||
| Mailing Address | 45-077 WAIKALUA RD APT F KANEOHE, HI 96744-2774 United States Phone: 808-389-1027 | Fax:833-479-0192 | ||||||||
| Primary Practice Address | 1150 S KING ST STE 302 HONOLULU, HI 96814-1951 United States Phone: 808-389-1027 | Fax: | ||||||||
| Secondary Practice Address(es) | 45-077 WAIKALUA RD APT F | ||||||||
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