Provider Demographics
NPI:1245571744
Name:HIRAGA-NUCCIO, MADELEINE MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:MARIE
Last Name:HIRAGA-NUCCIO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6470 KIPAPA RD
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-8623
Mailing Address - Country:US
Mailing Address - Phone:808-635-0447
Mailing Address - Fax:
Practice Address - Street 1:3-3204 KUHIO HWY
Practice Address - Street 2:SUITE 104
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1135
Practice Address - Country:US
Practice Address - Phone:808-274-3883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical