Provider Demographics
NPI:1982940110
Name:KLODA, ROBIN J
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:J
Last Name:KLODA
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 1:15-2777 MAIKO ST
Mailing Address - Street 2:
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-9133
Mailing Address - Country:US
Mailing Address - Phone:808-965-9796
Mailing Address - Fax:
Practice Address - Street 1:15-2777 MAIKO ST
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-9133
Practice Address - Country:US
Practice Address - Phone:808-965-9796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-16
Last Update Date:2012-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker