Provider Demographics
NPI:1881350353
Name:MAITE E ANASAGASTI ROBLES MFT LLC
Entity type:Organization
Organization Name:MAITE E ANASAGASTI ROBLES MFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAITE
Authorized Official - Middle Name:EUKENE
Authorized Official - Last Name:ANASAGASTI ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:808-557-2680
Mailing Address - Street 1:73-4316 ILIILI ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-9504
Mailing Address - Country:US
Mailing Address - Phone:808-557-2680
Mailing Address - Fax:
Practice Address - Street 1:73-4316 ILIILI ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-9504
Practice Address - Country:US
Practice Address - Phone:808-557-2680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty