Provider Demographics
NPI:1356196695
Name:MCLAIN, JAIDYN A
Entity type:Individual
Prefix:
First Name:JAIDYN
Middle Name:A
Last Name:MCLAIN
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 1:1009 KAPIOLANI BLVD APT 3411
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2175
Mailing Address - Country:US
Mailing Address - Phone:410-940-8295
Mailing Address - Fax:
Practice Address - Street 1:458 MANAWAI ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4604
Practice Address - Country:US
Practice Address - Phone:808-763-7352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker