| Johanna L Park, Lmhc | |
|
399 E Kawili St Suite 202 Hilo HI 96720-5075 | |
| (808) 315-1432 | |
| Not Available |
| Full Name | Johanna L Park, Lmhc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 399 E Kawili St, Hilo, Hawaii |
| Authorized Official Name and Position | Johanna Lynn Park (OWNER) |
| Authorized Official Contact | 8083151432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Johanna L Park, Lmhc Po Box 6111 Kamuela HI 96743-6111 Ph: (808) 315-1432 | Johanna L Park, Lmhc 399 E Kawili St Suite 202 Hilo HI 96720-5075 Ph: (808) 315-1432 |
| NPI Number | 1093252124 |
|---|---|
| Provider Enumeration Date | 01/27/2017 |
| Last Update Date | 01/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093252124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LMHC 427 (Hawaii) | Primary |
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