Provider Demographics
NPI:1457629073
Name:LAVE, FAIGATA
Entity Type:Individual
Prefix:
First Name:FAIGATA
Middle Name:
Last Name:LAVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85-979 MILL ST
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-2645
Mailing Address - Country:US
Mailing Address - Phone:808-696-9498
Mailing Address - Fax:808-696-9403
Practice Address - Street 1:85-979 MILL ST
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2645
Practice Address - Country:US
Practice Address - Phone:808-696-9498
Practice Address - Fax:808-696-9403
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health