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General NPI Number Information
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NPI Number | 1891215968
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Entity Type | Individual
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Provider Name | MICHAEL YADAO-EVANS
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Gender | Male
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 615 PIIKOI ST STE 203
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City | HONOLULU
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State | HI
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Zip | 96814
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Country | US
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Telephone | 808-589-1829
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Fax |
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Provider Business Mailing Address
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Address Line | 95-055 WAIKALANI DR APT H103
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City | MILILANI
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State | HI
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Zip | 96789-3346
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Country | US
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Telephone | 808-391-5038
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT-708
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License Number State | HI
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