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General NPI Number Information
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NPI Number | 1114286002
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Entity Type | Individual
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Provider Name | MARIA RUIZ TIERRA A.A./A.S.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 05/11/2012
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Provider Practice Location Address
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Address Line | 1130 N NIMITZ HWY C-301
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City | HONOLULU
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State | HI
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Zip | 96817-4579
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Country | US
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Telephone | 808-292-1073
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Fax | 808-845-7955
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Provider Business Mailing Address
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Address Line | 1130 N NIMITZ HWY C-301
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City | HONOLULU
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State | HI
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Zip | 96817-4579
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Country | US
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Telephone | 808-292-1073
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Fax | 808-845-7955
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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