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General NPI Number Information
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NPI Number | 1518707215
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Entity Type | Individual
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Provider Name | DEBBIE LYNN PENNUTO CSAC
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Gender | Female
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 47-388 HUI IWA ST STE 14
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City | KANEOHE
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State | HI
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Zip | 96744-4427
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Country | US
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Telephone | 808-399-2288
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Fax |
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Provider Business Mailing Address
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Address Line | 91-1474 WAHANE ST
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City | KAPOLEI
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State | HI
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Zip | 96707-3114
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Country | US
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Telephone | 808-807-7413
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | HI
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