Provider Demographics
NPI:1790171080
Name:HANATO-SMITH, THEA SACHI OLINA
Entity Type:Individual
Prefix:
First Name:THEA
Middle Name:SACHI OLINA
Last Name:HANATO-SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:THEA
Other - Middle Name:SACHI OLINA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-0284
Mailing Address - Country:US
Mailing Address - Phone:808-969-1935
Mailing Address - Fax:808-969-3276
Practice Address - Street 1:622 HINANO ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4427
Practice Address - Country:US
Practice Address - Phone:808-969-1935
Practice Address - Fax:808-969-3276
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor