Provider Demographics
NPI:1750819934
Name:LEE-ROCHE, DAYLE-ANN MIKI (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:DAYLE-ANN
Middle Name:MIKI
Last Name:LEE-ROCHE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:DAYLE-ANN
Other - Middle Name:MIKI
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:8300 ESTERS BLVD STE 900
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-2233
Mailing Address - Country:US
Mailing Address - Phone:415-424-4266
Mailing Address - Fax:415-520-6633
Practice Address - Street 1:500 ALA MOANA BLVD STE 7400
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4902
Practice Address - Country:US
Practice Address - Phone:415-424-4266
Practice Address - Fax:415-520-6633
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT-462106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist