Provider Demographics
NPI:1821246042
Name:ISHIBASHI, SKYLANE KALEOOKALANI (MA)
Entity Type:Individual
Prefix:MR
First Name:SKYLANE
Middle Name:KALEOOKALANI
Last Name:ISHIBASHI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:SKY
Other - Middle Name:
Other - Last Name:ISHIBASHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:234 WAIANUENUE AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2418
Mailing Address - Country:US
Mailing Address - Phone:808-935-7949
Mailing Address - Fax:808-935-5996
Practice Address - Street 1:234 WAIANUENUE AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2418
Practice Address - Country:US
Practice Address - Phone:808-935-7949
Practice Address - Fax:808-935-5996
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist