Provider Demographics
NPI:1841023884
Name:SCHRIEFER, JOAN R
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:R
Last Name:SCHRIEFER
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 1:1063 LOWER MAIN ST APT 513
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2028
Mailing Address - Country:US
Mailing Address - Phone:808-495-9246
Mailing Address - Fax:
Practice Address - Street 1:1063 LOWER MAIN ST APT 513
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2028
Practice Address - Country:US
Practice Address - Phone:808-495-9246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI23-300342106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician