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NPI Code Detail

MEDICARE: KEITH MERLIN KAULULAAU

MEDICARE: KEITH MERLIN KAULULAAU
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 : 1477883742
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH MERLIN KAULULAAU
Provider Business Mailing Address
First Line : 10525 YUBA CT
Second Line :
City : RENO
State : NV
Zip : 89521-4140
Country : US
Telephone Number : 808-753-3109
Fax Number :
Provider Business Practice Location Address
First Line : 1101 W MOANA LN STE 2
Second Line :
City : RENO
State : NV
Zip : 89509-4734
Country : US
Telephone Number : 775-337-2394
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2010
Last Update Date : 01/07/2010

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Directions to “ KEITH MERLIN KAULULAAU ” Practice Location

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