Healthcare Provider Details

I. General information

NPI: 1861036071
Provider Name (Legal Business Name): INTEGRATIVE WELL-BEING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 10/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 PUALANI WAY APT 3004
HONOLULU HI
96815-3940
US

IV. Provider business mailing address

2600 PUALANI WAY APT 3004
HONOLULU HI
96815-3940
US

V. Phone/Fax

Practice location:
  • Phone: 808-278-9150
  • Fax:
Mailing address:
  • Phone: 808-278-9150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DENISE SIMAO MARQUES
Title or Position: FOUNDER
Credential: PH.D.
Phone: 808-278-9150