Provider Demographics
NPI:1447561832
Name:LEE, KEPUANANI MICHELE
Entity Type:Individual
Prefix:MS
First Name:KEPUANANI
Middle Name:MICHELE
Last Name:LEE
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 1:91-1841 FT WEAVER ROAD
Mailing Address - Street 2:CHILD AND FAMILY SERVICE
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706
Mailing Address - Country:US
Mailing Address - Phone:808-881-3500
Mailing Address - Fax:
Practice Address - Street 1:91-1841 FT. WEAVER ROAD
Practice Address - Street 2:CHILD AND FAMILY SERVICE
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706
Practice Address - Country:US
Practice Address - Phone:808-681-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIH00982473106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist