Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003067760 |
---|---|
Provider Name | Atalili Sagapolutele |
First Address | Pearl City, HI 96782-1478 |
Second Address | Pearl City, HI 96782-1478 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2008 |
Last Update Date | 30/09/2008 |