Healthcare Provider Details

I. General information

NPI: 1689617391
Provider Name (Legal Business Name): MARCIA TSUE HORIUCHI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 KAPIOLANI BLVD. #936
HONOLULU HI
96814
US

IV. Provider business mailing address

2101 NUUANU AVENUE #1004
HONOLULU HI
96817-1767
US

V. Phone/Fax

Practice location:
  • Phone: 808-566-8241
  • Fax: 808-538-0474
Mailing address:
  • Phone: 808-534-1269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3240
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: