Provider Demographics
NPI:1700927217
Name:SUBER, ANGELEA MICHELLE (ND)
Entity Type:Individual
Prefix:DR
First Name:ANGELEA
Middle Name:MICHELLE
Last Name:SUBER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:ANGELEA
Other - Middle Name:MICHELLE
Other - Last Name:HOLLANDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:65-1235 A OPELO ROAD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743
Mailing Address - Country:US
Mailing Address - Phone:808-887-1210
Mailing Address - Fax:
Practice Address - Street 1:65-1235 A OPELO ROAD
Practice Address - Street 2:SUITE 5
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743
Practice Address - Country:US
Practice Address - Phone:808-887-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI121175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath