Provider Demographics
NPI:1285139618
Name:ROSALA, MINAKO A (LMHC)
Entity type:Individual
Prefix:MS
First Name:MINAKO
Middle Name:A
Last Name:ROSALA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7524 KEKAA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-2806
Mailing Address - Country:US
Mailing Address - Phone:808-386-6414
Mailing Address - Fax:
Practice Address - Street 1:7524 KEKAA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-2806
Practice Address - Country:US
Practice Address - Phone:808-386-6414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-213101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health