Provider Demographics
NPI:1134216989
Name:LEE, C. JARNIE WJ (EDD)
Entity type:Individual
Prefix:DR
First Name:C. JARNIE
Middle Name:WJ
Last Name:LEE
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:DR
Other - First Name:CAROLYN JARNIE
Other - Middle Name:WJ
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDD
Mailing Address - Street 1:101 AUPUNI STREET
Mailing Address - Street 2:SUITE 119
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-961-3616
Mailing Address - Fax:
Practice Address - Street 1:101 AUPUNI STREET
Practice Address - Street 2:SUITE 119
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-961-3616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI327103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00C0026660OtherHMSA QUEST
HI00C0026660OtherHMSA
HI02397901Medicaid
HI00C0026660OtherHMSA QUEST