Healthcare Provider Details
I. General information
NPI: 1497991442
Provider Name (Legal Business Name): HAROLYN PUANANI WOLFGRAMM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/22/2008
Last Update Date: 12/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3627 KILAUEA AVE SUITE 408
HONOLULU HI
96816-2317
US
IV. Provider business mailing address
1700 LANAKILA AVE
HONOLULU HI
96817-2115
US
V. Phone/Fax
- Phone: 808-733-9260
- Fax: 808-733-9187
- Phone: 808-832-3823
- Fax: 808-832-5850
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: