Provider Demographics
NPI:1659731123
Name:GREENLEAF, EDWINA LOKELANI (BA-PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:EDWINA
Middle Name:LOKELANI
Last Name:GREENLEAF
Suffix:
Gender:F
Credentials:BA-PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 MAKAENA PL
Mailing Address - Street 2:
Mailing Address - City:KAUNAKAKAI
Mailing Address - State:HI
Mailing Address - Zip Code:96748
Mailing Address - Country:US
Mailing Address - Phone:808-553-7878
Mailing Address - Fax:
Practice Address - Street 1:65 MAKAENA PL
Practice Address - Street 2:
Practice Address - City:KAUNAKAKAI
Practice Address - State:HI
Practice Address - Zip Code:96748
Practice Address - Country:US
Practice Address - Phone:808-553-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker