Provider Demographics
NPI:1013508415
Name:MARY ANN ERWIN MFT LLC
Entity Type:Organization
Organization Name:MARY ANN ERWIN MFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:808-927-0775
Mailing Address - Street 1:1128 PUEO ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5120
Mailing Address - Country:US
Mailing Address - Phone:808-734-2357
Mailing Address - Fax:
Practice Address - Street 1:1128 PUEO ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5120
Practice Address - Country:US
Practice Address - Phone:808-927-0755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty