Provider Demographics
NPI:1982851473
Name:LUIS, PAMELA KAY (MFT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAY
Last Name:LUIS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:KAY
Other - Last Name:LUIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:P.O. BOX 472
Mailing Address - Street 2:15-1884 7TH AVENUE
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749
Mailing Address - Country:US
Mailing Address - Phone:808-987-7879
Mailing Address - Fax:808-982-8092
Practice Address - Street 1:15-1884 7TH AVENUE
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749
Practice Address - Country:US
Practice Address - Phone:808-987-7879
Practice Address - Fax:808-982-8092
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist