Provider Demographics
NPI:1326366030
Name:JONES, MICHELE (LAC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:MARIE
Other - Last Name:HOLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:HC 1 BOX 488
Mailing Address - Street 2:
Mailing Address - City:KAUNAKAKAI
Mailing Address - State:HI
Mailing Address - Zip Code:96748-8608
Mailing Address - Country:US
Mailing Address - Phone:808-553-3930
Mailing Address - Fax:
Practice Address - Street 1:40 ALA MALAMA ST
Practice Address - Street 2:#206
Practice Address - City:KAUNAKAKAI
Practice Address - State:HI
Practice Address - Zip Code:96748-8608
Practice Address - Country:US
Practice Address - Phone:808-553-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-538171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist