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General NPI Number Information
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NPI Number | 1801731294
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Entity Type | Organization
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Legal Business Name | FORMOSA ROOTS COUNSELING
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 201 PIIMAUNA ST
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City | MAKAWAO
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State | HI
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Zip | 96768-8871
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Country | US
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Telephone | 601-208-0935
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Fax |
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Provider Business Mailing Address
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Address Line | 201 PIIMAUNA ST
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City | MAKAWAO
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State | HI
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Zip | 96768-8871
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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 | OWNER
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Name | ANN COLLINS
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Credential | MFT
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Telephone | 808-741-5668
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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 |
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License Number State |
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