Healthcare Provider Details

I. General information

NPI: 1780420026
Provider Name (Legal Business Name): CLAIRE K.M. OBRIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2024
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45-549 PLUMERIA ST
HONOKAA HI
96727-6902
US

IV. Provider business mailing address

45-549 PLUMERIA ST
HONOKAA HI
96727-6902
US

V. Phone/Fax

Practice location:
  • Phone: 808-775-7204
  • Fax:
Mailing address:
  • Phone:
  • 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: