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General NPI Number Information
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NPI Number | 1093623936
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Entity Type | Organization
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Legal Business Name | STILLWATER WELLNESS LLC
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 67 KEOKEA LOOP
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City | HILO
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State | HI
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Zip | 96720-4980
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Country | US
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Telephone | 808-481-6292
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Fax |
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Provider Business Mailing Address
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Address Line | 15-2660 PAHOA VILLAGE RD STE 203-639
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City | PAHOA
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State | HI
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Zip | 96778-6720
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Country | US
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Telephone | 808-481-6292
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | LISA LUCIA
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Credential |
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Telephone | 808-481-6292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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