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NPI 1568009983

NPI 1568009983 : MARIE FE PAGARAGAN : WAIPAHU, HI

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General NPI Number Information
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    NPI Number           |    1568009983
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    Entity Type          |    Individual 
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    Provider Name        |    MARIE FE PAGARAGAN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/04/2019
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    Last Update Date     |    12/04/2019
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Provider Practice Location Address
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    Address Line         |    94-1221 KA UKA BLVD 
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    City                 |    WAIPAHU
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    State                |    HI
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    Zip                  |    96797-6202
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    Country              |    US
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    Telephone            |    808-773-2792
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2516 ROSE ST APT A 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96819-5606
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    Country              |    US
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    Telephone            |    
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    RBT-19-107617
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    License Number State |    HI
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