Healthcare Provider Details

I. General information

NPI: 1437558665
Provider Name (Legal Business Name): CECILIA GREGORY LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CECILIA QUINONES

II. Dates (important events)

Enumeration Date: 08/13/2014
Last Update Date: 08/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2239 N SCHOOL ST
HONOLULU HI
96819-2539
US

IV. Provider business mailing address

2239 N SCHOOL ST
HONOLULU HI
96819-2539
US

V. Phone/Fax

Practice location:
  • Phone: 808-791-9400
  • Fax: 808-847-1144
Mailing address:
  • Phone: 808-791-9400
  • Fax: 808-847-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2035
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: