Provider Demographics
NPI:1740684711
Name:POZO, DOMINIQUE (LPCC, LMT)
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:
Last Name:POZO
Suffix:
Gender:F
Credentials:LPCC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 W KUIAHA RD
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-5636
Mailing Address - Country:US
Mailing Address - Phone:808-280-5203
Mailing Address - Fax:
Practice Address - Street 1:16 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:PAIA
Practice Address - State:HI
Practice Address - Zip Code:96779
Practice Address - Country:US
Practice Address - Phone:808-280-5203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2023-0094101YM0800X
HIMAT-6984225700000X
NM7008225700000X
HIMHC-777-0101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist