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NPI 1629484472

NPI 1629484472 : KATHLEEN RUBIO : HONOLULU, HI

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General NPI Number Information
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    NPI Number           |    1629484472
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    Entity Type          |    Individual 
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    Provider Name        |    KATHLEEN RUBIO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/01/2014
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    Last Update Date     |    03/09/2022
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Provider Practice Location Address
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    Address Line         |    1441 KAPIOLANI BLVD 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96814-4402
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    Country              |    US
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    Telephone            |    808-432-7600
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1441 KAPIOLANI BLVD 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96814-4402
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    Country              |    US
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    Telephone            |    808-432-7600
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    L7369
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    License Number State |    OR
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Taxonomy #3
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    LCSW-4482
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    License Number State |    HI
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