DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: EMAN'ON FEARLESS WANDERER

MEDICARE: EMAN'ON FEARLESS WANDERER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health WorkerHI
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)171M00000XCA
3106S00000XBehavior TechnicianHI

General Provider Information

NPI Number : 1740584218
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMAN'ON FEARLESS WANDERER
Provider Business Mailing Address
First Line : PO BOX 1841
Second Line :
City : MAKAWAO
State : HI
Zip : 96768-1841
Country : US
Telephone Number : 808-283-3016
Fax Number :
Provider Business Practice Location Address
First Line : 1390 MILLER ST
Second Line :
City : HONOLULU
State : HI
Zip : 96813-2493
Country : US
Telephone Number : 808-784-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2010
Last Update Date : 11/20/2024

Similar Medicare Providers

1013876499 — ABIGALE LYN DEFRIEZ
Practice Location Address:
1390 MILLER ST
HONOLULU, HI
96813-2493
Practice Phone: 254-499-8194
Practice Fax:
1487503488 — GLORIMAR HEARD
Practice Location Address:
1390 MILLER ST
HONOLULU, HI
96813-2493
Practice Phone: 347-599-4837
Practice Fax:
1952834814 — AMBER DESROCHES
Practice Location Address:
1390 MILLER ST
HONOLULU, HI
96813-2493
Practice Phone: 808-427-9257
Practice Fax:
1508373242 — JOSLYN HOWANYK
Practice Location Address:
1390 MILLER ST
HONOLULU, HI
96813-2493
Practice Phone: 808-427-9257
Practice Fax:
1528564648 — MYRELLA LIZETH CUELLAR
Practice Location Address:
1390 MILLER ST
HONOLULU, HI
96813-2493
Practice Phone: 808-784-6200
Practice Fax:
1801363486 — MR. JORDAN AGUSTIN
Practice Location Address:
1390 MILLER ST
HONOLULU, HI
96813-2493
Practice Phone: 808-427-9257
Practice Fax:

Directions to “ EMAN'ON FEARLESS WANDERER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.