Provider Demographics
NPI:1891072138
Name:NEAL, KIMBERLY SUE (MA)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:SUE
Last Name:NEAL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1369 AUPUPU ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4142
Mailing Address - Country:US
Mailing Address - Phone:808-284-6624
Mailing Address - Fax:
Practice Address - Street 1:606 CORAL ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5135
Practice Address - Country:US
Practice Address - Phone:808-791-6713
Practice Address - Fax:808-791-6198
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist