Provider Demographics
NPI:1063937506
Name:YUW-MIRANDA, JACQUELINE GOOLIAN
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:GOOLIAN
Last Name:YUW-MIRANDA
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:PO BOX 6224
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-8924
Mailing Address - Country:US
Mailing Address - Phone:808-557-6665
Mailing Address - Fax:
Practice Address - Street 1:69 RAILROAD AVE UNIT 6
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-7509
Practice Address - Country:US
Practice Address - Phone:808-935-7949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-06
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor