Provider Demographics
NPI:1407414196
Name:KIAHA, DESIREE (MSW)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:KIAHA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 HOOKAHI ST STE 207
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1466
Mailing Address - Country:US
Mailing Address - Phone:808-757-0460
Mailing Address - Fax:808-242-6650
Practice Address - Street 1:130B MOOMOMI AVE
Practice Address - Street 2:
Practice Address - City:HO'OLEHUA
Practice Address - State:HI
Practice Address - Zip Code:96729
Practice Address - Country:US
Practice Address - Phone:808-757-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker