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General NPI Number Information
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NPI Number | 1518102250
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Entity Type | Individual
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Provider Name | DESRAE K KAHALE NCC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 46-001 KAMEHAMEHA HWY #217
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City | KANEOHE
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State | HI
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Zip | 96744-3711
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Country | US
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Telephone | 808-722-2437
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Fax |
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Provider Business Mailing Address
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Address Line | 304 KAIMAKE LOOP
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City | KAILUA
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State | HI
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Zip | 96734-2017
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Country | US
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Telephone | 808-722-2437
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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 | 200
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License Number State | HI
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