Provider Demographics
NPI:1891578225
Name:PAUOLE, ANGEL KAILANI KALEHUAWEHE
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:KAILANI KALEHUAWEHE
Last Name:PAUOLE
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 1:656 ANELA PL
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1518
Mailing Address - Country:US
Mailing Address - Phone:808-419-2669
Mailing Address - Fax:
Practice Address - Street 1:795 ONEHEE AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1757
Practice Address - Country:US
Practice Address - Phone:808-727-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician