Provider Demographics
NPI:1174867519
Name:MIKI-O'DONOVAN, SATOKO (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:SATOKO
Middle Name:
Last Name:MIKI-O'DONOVAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 PONIU CIR
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2909
Mailing Address - Country:US
Mailing Address - Phone:808-242-9398
Mailing Address - Fax:808-242-9398
Practice Address - Street 1:135 S WAKEA AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1385
Practice Address - Country:US
Practice Address - Phone:808-276-2092
Practice Address - Fax:808-242-9398
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI29101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health