Provider Demographics
NPI:1649604539
Name:VAHAI, NICOLE DEIRDRE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:DEIRDRE
Last Name:VAHAI
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 1:73-1111 NUUANU PL UNIT N201
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-7520
Mailing Address - Country:US
Mailing Address - Phone:808-990-1213
Mailing Address - Fax:
Practice Address - Street 1:234 WAIANUENUE AVE STE 215
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2418
Practice Address - Country:US
Practice Address - Phone:808-990-1213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health