Provider Demographics
NPI:1417696071
Name:SAELUA, SUZZANA JUNE
Entity Type:Individual
Prefix:
First Name:SUZZANA
Middle Name:JUNE
Last Name:SAELUA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1010 KAIMALIE ST APT S6
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-5040
Mailing Address - Country:US
Mailing Address - Phone:808-271-5290
Mailing Address - Fax:
Practice Address - Street 1:91-1010 KAIMALIE ST APT S6
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-5040
Practice Address - Country:US
Practice Address - Phone:808-271-5290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician