Provider Demographics
NPI:1417274853
Name:OMOTO, EMILEE LILIAOKAHAKU (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:EMILEE
Middle Name:LILIAOKAHAKU
Last Name:OMOTO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:EMILEE
Other - Middle Name:LILIAOKAHAKU
Other - Last Name:DUNLAP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2176 LAUWILIWILI ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1881
Mailing Address - Country:US
Mailing Address - Phone:808-202-0919
Mailing Address - Fax:808-200-4955
Practice Address - Street 1:2176 LAUWILIWILI ST
Practice Address - Street 2:UNIT 1
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1881
Practice Address - Country:US
Practice Address - Phone:808-202-0919
Practice Address - Fax:808-200-4955
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI363106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI755332Medicaid