Healthcare Provider Details

I. General information

NPI: 1982026993
Provider Name (Legal Business Name): MS. CHAYNEE KUAMOO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2014
Last Update Date: 04/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 WAILUKU DR STE 5
HILO HI
96720-2488
US

IV. Provider business mailing address

305 WAILUKU DR STE 5
HILO HI
96720-2488
US

V. Phone/Fax

Practice location:
  • Phone: 808-238-0270
  • Fax:
Mailing address:
  • Phone: 808-238-0270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: