Provider Demographics
NPI:1225809486
Name:KEALOHA, MARLEE KAIULANI
Entity Type:Individual
Prefix:
First Name:MARLEE
Middle Name:KAIULANI
Last Name:KEALOHA
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 1:2439 KAPIOLANI BLVD APT 202
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-4675
Mailing Address - Country:US
Mailing Address - Phone:808-754-0065
Mailing Address - Fax:
Practice Address - Street 1:1300 HALONA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2796
Practice Address - Country:US
Practice Address - Phone:808-847-3285
Practice Address - Fax:808-841-1485
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2686104100000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker