Provider Demographics
NPI:1477725125
Name:ANDERSON, ULA RAINE (LMFT)
Entity Type:Individual
Prefix:
First Name:ULA
Middle Name:RAINE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 269
Mailing Address - Street 2:
Mailing Address - City:PAPAIKOU
Mailing Address - State:HI
Mailing Address - Zip Code:96781-0269
Mailing Address - Country:US
Mailing Address - Phone:808-443-7700
Mailing Address - Fax:
Practice Address - Street 1:190 KEAWE ST STE 22
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2849
Practice Address - Country:US
Practice Address - Phone:808-443-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI145106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist