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General NPI Number Information
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NPI Number | 1780843359
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Entity Type | Individual
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Provider Name | GRACE MADARANG BARRIENTOS LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 02/22/2019
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Provider Practice Location Address
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Address Line | 305 WAILUKU DR STE 5
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City | HILO
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State | HI
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Zip | 96720-2488
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Country | US
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Telephone | 808-238-0270
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Fax | 808-443-0070
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Provider Business Mailing Address
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Address Line | PO BOX 4624
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City | HILO
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State | HI
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Zip | 96720-0624
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Country | US
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Telephone | 808-895-4850
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Fax | 808-934-0071
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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 | LCSW-3888
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License Number State | HI
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