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General NPI Number Information
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NPI Number | 1558887794
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Entity Type | Individual
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Provider Name | LESLIE KALANI CHUNG LMFT
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Gender | Male
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 45-845 POOKELA ST
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City | KANEOHE
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State | HI
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Zip | 96744-5700
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Country | US
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Telephone | 808-387-9668
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Fax |
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Provider Business Mailing Address
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Address Line | 94-1148 AWAIKI ST
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City | WAIPAHU
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State | HI
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Zip | 96797-3269
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Country | US
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Telephone | 808-387-9668
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT-529
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License Number State | HI
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