Provider Demographics
NPI:1124623186
Name:LULKER, NOZOMI
Entity type:Individual
Prefix:MRS
First Name:NOZOMI
Middle Name:
Last Name:LULKER
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 1:2069 CALIFORNIA AVE APT 11G
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-2777
Mailing Address - Country:US
Mailing Address - Phone:808-492-7530
Mailing Address - Fax:
Practice Address - Street 1:2069 CALIFORNIA AVE APT 11G
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2777
Practice Address - Country:US
Practice Address - Phone:808-492-7530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty