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General NPI Number Information
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NPI Number | 1396111209
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Entity Type | Individual
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Provider Name | DARREN HIDESHI IWAMOTO ED.D., LMHC
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Gender | Male
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Dates
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Enumeration Date | 08/14/2015
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 3615 HARDING AVE SUITE 509
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City | HONOLULU
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State | HI
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Zip | 96816-3735
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Country | US
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Telephone | 808-739-1992
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Fax |
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Provider Business Mailing Address
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Address Line | 2302 AHAIKI ST
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City | PEARL CITY
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State | HI
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Zip | 96782-1105
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Country | US
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Telephone | 808-457-8714
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHC-187
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License Number State | HI
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