Provider Demographics
NPI:1285018028
Name:MOE, DAWNLYNN
Entity Type:Individual
Prefix:
First Name:DAWNLYNN
Middle Name:
Last Name:MOE
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 1:875 WAIMANU ST STE 624
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5265
Mailing Address - Country:US
Mailing Address - Phone:808-791-6713
Mailing Address - Fax:808-791-6081
Practice Address - Street 1:875 WAIMANU ST STE 624
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5265
Practice Address - Country:US
Practice Address - Phone:808-791-6713
Practice Address - Fax:808-791-6081
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker