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General NPI Number Information
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NPI Number | 1437970464
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Entity Type | Individual
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Provider Name | JAMAICA ANN MOAKE LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 13-154 PUAKENIKENI PLACE
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City | PAHOA
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State | HI
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Zip | 96778
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Country | US
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Telephone | 808-937-6923
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Fax |
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Provider Business Mailing Address
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Address Line | RR 2 BOX 4210
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City | PAHOA
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State | HI
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Zip | 96778-9723
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Country | US
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Telephone | 808-937-6923
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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 | 1067
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License Number State | HI
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