Provider Demographics
NPI:1396998555
Name:DE SOTO, KATE LEE ESTHER
Entity type:Individual
Prefix:MS
First Name:KATE
Middle Name:LEE ESTHER
Last Name:DE SOTO
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 1:337 NOHEA ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-5451
Mailing Address - Country:US
Mailing Address - Phone:808-554-7417
Mailing Address - Fax:
Practice Address - Street 1:337 NOHEA ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-5451
Practice Address - Country:US
Practice Address - Phone:808-554-7417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-40551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical