Provider Demographics
NPI:1376794305
Name:BOND, MARLITA
Entity Type:Individual
Prefix:
First Name:MARLITA
Middle Name:
Last Name:BOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARLIE
Other - Middle Name:
Other - Last Name:BOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1843 LUSITANA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-1533
Mailing Address - Country:US
Mailing Address - Phone:808-348-2528
Mailing Address - Fax:808-074-8088
Practice Address - Street 1:1100 ALAKEA ST STE 900
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2851
Practice Address - Country:US
Practice Address - Phone:808-523-7771
Practice Address - Fax:808-523-1997
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIH01095553106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist