Provider Demographics
NPI:1326234915
Name:NUBLA, VINCENT E (PHD, LMFT)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:E
Last Name:NUBLA
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 IMI KALA ST STE 205
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1209
Mailing Address - Country:US
Mailing Address - Phone:808-242-1660
Mailing Address - Fax:808-242-6650
Practice Address - Street 1:220 IMI KALA ST STE 205
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1209
Practice Address - Country:US
Practice Address - Phone:808-242-1660
Practice Address - Fax:808-242-6650
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILMFT-72106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist