Provider Demographics
NPI:1194960484
Name:CHARRON, DONNA M (MA, MFT)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:M
Last Name:CHARRON
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6395 KAWAIHAU RD
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-9111
Mailing Address - Country:US
Mailing Address - Phone:808-823-6696
Mailing Address - Fax:
Practice Address - Street 1:6395 KAWAIHAU RD
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-9111
Practice Address - Country:US
Practice Address - Phone:808-823-6696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI200106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist