Provider Demographics
NPI:1427544485
Name:PACHECO, MARY ELIZABETH UILANI
Entity Type:Individual
Prefix:
First Name:MARY ELIZABETH
Middle Name:UILANI
Last Name:PACHECO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY ELIZABETH
Other - Middle Name:UILANI
Other - Last Name:KEALOHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:46-263 HEEIA ST
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-4117
Mailing Address - Country:US
Mailing Address - Phone:808-728-4222
Mailing Address - Fax:
Practice Address - Street 1:47-388 HUI IWA ST STE 11
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-4427
Practice Address - Country:US
Practice Address - Phone:808-728-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)