Provider Demographics
NPI:1760026322
Name:KRAMER-DIEWOLD, RACHEL ERIN
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ERIN
Last Name:KRAMER-DIEWOLD
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 1:905 KALANIANAOLE HWY SPC 5001
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4669
Mailing Address - Country:US
Mailing Address - Phone:808-741-2232
Mailing Address - Fax:
Practice Address - Street 1:203 KAPAA QUARRY PL
Practice Address - Street 2:#5002
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-9673
Practice Address - Country:US
Practice Address - Phone:808-741-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician