Healthcare Provider Details

I. General information

NPI: 1023153707
Provider Name (Legal Business Name): NAOMI RUTH TSUNEYOSHI MC MENTAL HEALTH COU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4370 KUKUI GROVE STREET SUITE 3-211
LIHUE HI
96766
US

IV. Provider business mailing address

4370 KUKUI GROVE STREET SUITE 3-211
LIHUE HI
96766
US

V. Phone/Fax

Practice location:
  • Phone: 808-274-3190
  • Fax: 808-274-3194
Mailing address:
  • Phone: 808-274-3190
  • Fax: 808-274-3194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMHC164
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: