Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1041C0700X | Clinical Social Worker | 1763 | CO |
Y | 1041C0700X | Clinical Social Worker | LCSW 27347 | ID |
NPI | 1003161597 |
---|---|
Provider Name | Mr. Craig Mathew Lombardi |
First Address | Ewa Beach, HI 96706-6309 |
Second Address | Wahiawa, HI 96786 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2012 |
Last Update Date | 03/12/2018 |