Provider Demographics
NPI:1265834295
Name:FIALHO, MARISA (LMFT, CSAC)
Entity Type:Individual
Prefix:MS
First Name:MARISA
Middle Name:
Last Name:FIALHO
Suffix:
Gender:F
Credentials:LMFT, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3641
Mailing Address - Country:US
Mailing Address - Phone:808-483-0735
Mailing Address - Fax:
Practice Address - Street 1:1017 2ND AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3641
Practice Address - Country:US
Practice Address - Phone:808-483-0735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001118106H00000X
HI498106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist