Provider Demographics
NPI:1619481140
Name:WAHL, SANTINA APRIL
Entity Type:Individual
Prefix:
First Name:SANTINA
Middle Name:APRIL
Last Name:WAHL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANTINA
Other - Middle Name:APRIL
Other - Last Name:RAYMOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4876 ELIMA WAY APT A
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3045
Mailing Address - Country:US
Mailing Address - Phone:808-358-0399
Mailing Address - Fax:808-433-0399
Practice Address - Street 1:875 WAIMANU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5248
Practice Address - Country:US
Practice Address - Phone:808-791-6713
Practice Address - Fax:808-791-6081
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker