Provider Demographics
NPI:1235251166
Name:ESTONACTOC, ABYSSINIA DULAY (MA, MFT)
Entity Type:Individual
Prefix:MRS
First Name:ABYSSINIA
Middle Name:DULAY
Last Name:ESTONACTOC
Suffix:
Gender:F
Credentials:MA, MFT
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 894359
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-8323
Mailing Address - Country:US
Mailing Address - Phone:808-625-4417
Mailing Address - Fax:866-439-7420
Practice Address - Street 1:319A N CANE ST
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2109
Practice Address - Country:US
Practice Address - Phone:808-753-5370
Practice Address - Fax:866-439-7420
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI158106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist