Provider Demographics
NPI:1689846453
Name:ACOBA, IRISH (MFT)
Entity Type:Individual
Prefix:
First Name:IRISH
Middle Name:
Last Name:ACOBA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2176 LAUWILIWILI ST STE 1
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1882
Mailing Address - Country:US
Mailing Address - Phone:808-542-6064
Mailing Address - Fax:808-200-4955
Practice Address - Street 1:2176 LAUWILIWILI ST STE 1
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1882
Practice Address - Country:US
Practice Address - Phone:808-542-6064
Practice Address - Fax:808-200-4955
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI354106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist