Provider Demographics
NPI:1033411467
Name:FABIN, LYDELL CHRISTOPHER (MSW)
Entity Type:Individual
Prefix:MR
First Name:LYDELL
Middle Name:CHRISTOPHER
Last Name:FABIN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-459 HOOKANIKE ST. APT 65
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-0001
Mailing Address - Country:US
Mailing Address - Phone:808-358-1981
Mailing Address - Fax:
Practice Address - Street 1:98-459 HOOKANIKE ST APT 65
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2350
Practice Address - Country:US
Practice Address - Phone:808-358-1981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker