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General NPI Number Information
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NPI Number | 1902946023
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Entity Type | Individual
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Provider Name | GAYLE DUDOIT DIAZ MSW,LSW
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 JARRETT WHITE RD
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City | TAMC
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone | 808-222-6499
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Fax |
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Provider Business Mailing Address
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Address Line | 91-1068 KOANIMAKANI ST
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City | KAPOLEI
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State | HI
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Zip | 96707-2934
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Country | US
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Telephone | 808-222-6499
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1074
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License Number State | HI
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