Provider Demographics
NPI:1801238761
Name:TANAKA-NOGAWA, LUREEN YONG EA (MFT)
Entity type:Individual
Prefix:MRS
First Name:LUREEN
Middle Name:YONG EA
Last Name:TANAKA-NOGAWA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:LUREEN
Other - Middle Name:YONG EA
Other - Last Name:TANAKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 240222
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96824-0222
Mailing Address - Country:US
Mailing Address - Phone:808-630-1983
Mailing Address - Fax:
Practice Address - Street 1:1127 11TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2443
Practice Address - Country:US
Practice Address - Phone:808-630-1983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-20
Last Update Date:2013-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI264106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist