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NPI Code Detail

MEDICARE: CHRISTINE CECILE HUSTACE

MEDICARE: CHRISTINE CECILE HUSTACE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1093551756
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE CECILE HUSTACE
Provider Business Mailing Address
First Line : PO BOX 198900
Second Line : PMB 234
City : HAWI
State : HI
Zip : 96719
Country : US
Telephone Number : 808-987-6288
Fax Number :
Provider Business Practice Location Address
First Line : 88 KANOELEHUA AVE STE B107
Second Line :
City : HILO
State : HI
Zip : 96720-4685
Country : US
Telephone Number : 808-933-0610
Fax Number : 808-933-0558
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2024
Last Update Date : 07/02/2024

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Directions to “ CHRISTINE CECILE HUSTACE ” Practice Location

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