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General NPI Number Information
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NPI Number | 1548646516
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Entity Type | Individual
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Provider Name | MICHELLE PONTELL
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Gender | Female
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 142 KUPUOHI ST STE F4
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City | LAHAINA
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State | HI
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Zip | 96761-2711
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Country | US
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Telephone | 808-866-3005
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Fax | 808-442-1330
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Provider Business Mailing Address
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Address Line | 45 E KUU AKU LN UNIT 311
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City | LAHAINA
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State | HI
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Zip | 96761-2755
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Country | US
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Telephone | 808-866-3005
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Fax | 808-442-1330
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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 | 4123
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 2001
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License Number State | HI
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