Provider Demographics
NPI:1104199181
Name:KOBEY, DAMON
Entity Type:Individual
Prefix:
First Name:DAMON
Middle Name:
Last Name:KOBEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1841 FORT WEAVER RD
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1045 KILAUEA AVE
Practice Address - Street 2:#A
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4291
Practice Address - Country:US
Practice Address - Phone:808-935-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor