Provider Demographics
NPI:1114798097
Name:EVANS, MARGARET PUANANI (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:PUANANI
Last Name:EVANS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 WAILUKU DR # 5A
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2488
Mailing Address - Country:US
Mailing Address - Phone:808-785-3293
Mailing Address - Fax:808-443-0070
Practice Address - Street 1:305 WAILUKU DR # 5A
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2488
Practice Address - Country:US
Practice Address - Phone:808-785-3293
Practice Address - Fax:808-443-0070
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILSW-1340104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker