Provider Information for 1811245509
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DEBRA POOLE COUNADIS
Sex: Female
NPI: 1811245509
Last Updated: 2024-10-16
Certification Date: 2024-10-16
Certification Date: 2024-10-16
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1811245509 | ||||||||
| Enumeration Date | 2012-08-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 641 KAAAWA, HI 96730-0641 United States Phone: 808-233-9968 | Fax: | ||||||||
| Primary Practice Address | 51-436 KEKIO ROAD KAAAWA, HI 96730 United States Phone: 808-233-9968 | Fax: | ||||||||
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