Provider Demographics
NPI:1295034973
Name:AGOY, ARLENE ASUNCION (LSW)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:ASUNCION
Last Name:AGOY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 S HIGH ST
Mailing Address - Street 2:ROOM 301
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2102
Mailing Address - Country:US
Mailing Address - Phone:808-984-2136
Mailing Address - Fax:808-984-8222
Practice Address - Street 1:54 S HIGH ST
Practice Address - Street 2:ROOM 301
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2102
Practice Address - Country:US
Practice Address - Phone:808-984-2136
Practice Address - Fax:808-984-8222
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1282104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker