Provider Demographics
NPI:1750668240
Name:LITALIEN, DONECIA RENEE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:DONECIA
Middle Name:RENEE
Last Name:LITALIEN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2264 WAIKAHE CT
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3478
Mailing Address - Country:US
Mailing Address - Phone:808-220-5726
Mailing Address - Fax:
Practice Address - Street 1:2264 WAIKAHE CT
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3478
Practice Address - Country:US
Practice Address - Phone:808-220-5726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILSW-1543104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker