Provider Demographics
NPI:1114652161
Name:ISHIMURA, DIONNE MALIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIONNE
Middle Name:MALIA
Last Name:ISHIMURA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17694
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-0694
Mailing Address - Country:US
Mailing Address - Phone:808-838-9781
Mailing Address - Fax:
Practice Address - Street 1:94-1388 MOANIANI ST STE 207
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-6604
Practice Address - Country:US
Practice Address - Phone:808-838-9781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-48551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical