Provider Demographics
NPI:1982248951
Name:HANAIKE-MACPHERSON, DESTINEE M
Entity Type:Individual
Prefix:
First Name:DESTINEE
Middle Name:M
Last Name:HANAIKE-MACPHERSON
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 1:45-327 KAHOWAA PL
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2809
Mailing Address - Country:US
Mailing Address - Phone:808-599-0745
Mailing Address - Fax:
Practice Address - Street 1:45-327 KAHOWAA PL
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2809
Practice Address - Country:US
Practice Address - Phone:808-599-0745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-03
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician