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General NPI Number Information
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NPI Number | 1336962323
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Entity Type | Individual
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Provider Name | BRYANNA F.A. TATUPU-LEOPOLDO LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1001 KAMOKILA BLVD STE 249
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City | KAPOLEI
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State | HI
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Zip | 96707-2091
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Country | US
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Telephone | 808-695-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 N SCHOOL ST APT 4C
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City | HONOLULU
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State | HI
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Zip | 96817-2087
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Country | US
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Telephone | 808-392-0004
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4833
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License Number State | HI
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