Provider Demographics
NPI:1952720864
Name:HERRERA, YONIE KEALA (MHC)
Entity type:Individual
Prefix:MRS
First Name:YONIE
Middle Name:KEALA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:MRS
Other - First Name:YONIE
Other - Middle Name:KEALA
Other - Last Name:LEDWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:94-1506 LANIKUHANA AVE APT 582
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-2430
Mailing Address - Country:US
Mailing Address - Phone:808-954-2334
Mailing Address - Fax:
Practice Address - Street 1:94-1506 LANIKUHANA AVE APT 582
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-2430
Practice Address - Country:US
Practice Address - Phone:808-954-2334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMH-314101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health