Provider Demographics
NPI:1093387037
Name:DEMARCO, OLIVIA NICOLE
Entity Type:Individual
Prefix:MISS
First Name:OLIVIA
Middle Name:NICOLE
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99-870 IWAENA ST
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3278
Mailing Address - Country:US
Mailing Address - Phone:808-277-7736
Mailing Address - Fax:
Practice Address - Street 1:1917 COLBURN ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3248
Practice Address - Country:US
Practice Address - Phone:808-845-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician