Provider Demographics
NPI:1023426558
Name:SCHWARTZLOW, AILENE
Entity type:Individual
Prefix:
First Name:AILENE
Middle Name:
Last Name:SCHWARTZLOW
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:PO BOX 12123
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-7123
Mailing Address - Country:US
Mailing Address - Phone:808-463-4934
Mailing Address - Fax:
Practice Address - Street 1:1760 HONOAPIILANI HWY UNIT 12123
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-5085
Practice Address - Country:US
Practice Address - Phone:808-463-4934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-46301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical