Provider Demographics
NPI:1710347448
Name:JAHNS, JODIE MAE
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:MAE
Last Name:JAHNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:MAE
Other - Last Name:KINTOPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:234 WAIANUENUE AVE
Mailing Address - Street 2:STE. 215
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2418
Mailing Address - Country:US
Mailing Address - Phone:808-238-8525
Mailing Address - Fax:
Practice Address - Street 1:234 WAIANUENUE AVE
Practice Address - Street 2:STE. 215
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2418
Practice Address - Country:US
Practice Address - Phone:808-238-8525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional