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General NPI Number Information
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NPI Number | 1497181051
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Entity Type | Organization
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Legal Business Name | HO'OKO LLC
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 94-1221 KA UKA BLVD SUITE B202
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City | WAIPAHU
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State | HI
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Zip | 96797-6202
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Country | US
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Telephone | 808-226-9442
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Fax | 808-671-0222
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Provider Business Mailing Address
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Address Line | 94-1221 KA UKA BLVD SUITE B202
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City | WAIPAHU
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State | HI
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Zip | 96797-6202
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Country | US
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Telephone | 808-226-9442
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Fax | 808-671-0222
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | EDWINA REYES
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Credential | MFT, CSAC
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Telephone | 808-226-9442
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT-156
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License Number State | HI
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