Provider Demographics
NPI:1235617630
Name:SCHNACKENBERG, U'ILANI
Entity Type:Individual
Prefix:
First Name:U'ILANI
Middle Name:
Last Name:SCHNACKENBERG
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:HAWAII YOUTH CORRECTIONAL FACILITY
Mailing Address - Street 2:42-470 KALANIANAOLE HWY
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734
Mailing Address - Country:US
Mailing Address - Phone:808-266-9922
Mailing Address - Fax:
Practice Address - Street 1:HAWAII YOUTH CORRECTIONAL FACILITY
Practice Address - Street 2:42-470 KALANIANAOLE HWY
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4373
Practice Address - Country:US
Practice Address - Phone:808-266-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program