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General NPI Number Information
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NPI Number | 1538498720
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Entity Type | Individual
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Provider Name | KIRSTEN M.K. KWAN WING
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Gender | Female
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Dates
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Enumeration Date | 12/17/2009
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 65-1267 KAWAIHAE RD
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City | KAMUELA
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State | HI
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Zip | 96743-7345
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Country | US
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Telephone | 808-881-4745
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 435
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City | PAAUILO
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State | HI
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Zip | 96776-0435
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Country | US
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Telephone | 808-368-3644
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4312
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License Number State | HI
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