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General NPI Number Information
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NPI Number | 1841523552
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Entity Type | Individual
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Provider Name | JAMIE LEE HAUNANI KELIIKULI MFT
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Gender | Female
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Dates
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Enumeration Date | 09/13/2009
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 614 KILAUEA AVE STE 27
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City | HILO
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State | HI
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Zip | 96720-4253
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Country | US
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Telephone | 808-990-7181
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Fax |
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Provider Business Mailing Address
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Address Line | 614 KILAUEA AVE STE 27
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City | HILO
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State | HI
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Zip | 96720-4253
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Country | US
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Telephone | 808-319-1903
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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 | MFT600
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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