MEDICARE: HAWAII HOLISTIC THERAPY

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1730724345	OTHER	HI	MAISA ZIEGLER

General Provider Information

NPI Number	:	1871202515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAWAII HOLISTIC THERAPY

Provider Business Mailing Address
First Line	:	44-403 KANEOHE BAY DR
Second Line	:
City	:	KANEOHE
State	:	HI
Zip	:	96744-2611
Country	:	US
Telephone Number	:	808-429-4213
Fax Number	:

Provider Business Practice Location Address
First Line	:	44-403 KANEOHE BAY DR
Second Line	:
City	:	KANEOHE
State	:	HI
Zip	:	96744-2611
Country	:	US
Telephone Number	:	808-429-4213
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	MAISA LEILANI ZIEGLER
Credential	:	LCSW
Telephone Number	:	808-429-4213

Provider Enumeration Date	:	11/22/2022
Last Update Date	:	11/22/2022

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Directions to “HAWAII HOLISTIC THERAPY ” Practice Location

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