Provider Information for 1790409662
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NINA HOOMAIKAIANA PUCKETT LMHC
Sex: Female
NPI: 1790409662
Last Updated: 2022-10-03
Certification Date: 2022-10-03
Certification Date: 2022-10-03
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1790409662 | ||||||||
| Enumeration Date | 2022-10-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 65-1187 HOKUULA RD KAMUELA, HI 96743-8300 United States Phone: 808-557-3114 | Fax: | ||||||||
| Primary Practice Address | 65-1187 HOKUULA RD KAMUELA, HI 96743-8300 United States Phone: 808-557-3114 | Fax: | ||||||||
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