Provider Demographics
NPI:1669606224
Name:TAELE, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:TAELE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-111 WAIKAPOKI RD
Mailing Address - Street 2:APT. D
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2779
Mailing Address - Country:US
Mailing Address - Phone:808-393-7849
Mailing Address - Fax:
Practice Address - Street 1:45-111 WAIKAPOKI RD
Practice Address - Street 2:APT. D
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2779
Practice Address - Country:US
Practice Address - Phone:808-393-7849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor