Provider Demographics
NPI:1700206802
Name:DEMURA-DEVORE, HITOMI
Entity Type:Individual
Prefix:
First Name:HITOMI
Middle Name:
Last Name:DEMURA-DEVORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY AVE
Mailing Address - Street 2:APT 726
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-4904
Mailing Address - Country:US
Mailing Address - Phone:808-941-3717
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY AVE
Practice Address - Street 2:APT 726
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-4904
Practice Address - Country:US
Practice Address - Phone:808-941-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI39161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical