Provider Demographics
NPI:1821428566
Name:TARIK-GACHO, JEMARIE FERMIN (MAPC, NCC, CTTS)
Entity Type:Individual
Prefix:
First Name:JEMARIE
Middle Name:FERMIN
Last Name:TARIK-GACHO
Suffix:
Gender:F
Credentials:MAPC, NCC, CTTS
Other - Prefix:
Other - First Name:JEMARIE
Other - Middle Name:GACHO
Other - Last Name:AGANON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3-3122 KUHIO HWY STE A15
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1157
Mailing Address - Country:US
Mailing Address - Phone:808-246-9102
Mailing Address - Fax:808-246-8609
Practice Address - Street 1:3-3122 KUHIO HWY STE A15
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1157
Practice Address - Country:US
Practice Address - Phone:808-246-9102
Practice Address - Fax:808-246-8609
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-15
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health