Provider Demographics
NPI:1083711907
Name:TELEIA, JEANNE (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:TELEIA
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47-669 MELEKULA RD
Mailing Address - Street 2:#10
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-5455
Mailing Address - Country:US
Mailing Address - Phone:808-224-5008
Mailing Address - Fax:866-886-1743
Practice Address - Street 1:47-669 MELEKULA RD
Practice Address - Street 2:#10
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-5455
Practice Address - Country:US
Practice Address - Phone:808-224-5008
Practice Address - Fax:866-886-1743
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI123106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist