Healthcare Provider Details

I. General information

NPI: 1285564302
Provider Name (Legal Business Name): KRISTOPHER MARR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 LUNALILO HOME RD
HONOLULU HI
96825-3201
US

IV. Provider business mailing address

1237 LUNALILO HOME RD
HONOLULU HI
96825-3201
US

V. Phone/Fax

Practice location:
  • Phone: 808-221-4838
  • Fax:
Mailing address:
  • Phone: 808-221-4838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC-1212
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: