Provider Demographics
NPI:1396336020
Name:SANTOS-BALISACAN, TAYLOR U'ILAUNA'OLE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:U'ILAUNA'OLE
Last Name:SANTOS-BALISACAN
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 1:622 HINANO ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4427
Mailing Address - Country:US
Mailing Address - Phone:808-969-1935
Mailing Address - Fax:
Practice Address - Street 1:1546 LANIHAU PL
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-5531
Practice Address - Country:US
Practice Address - Phone:808-651-3732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker