Provider Demographics
NPI:1487436564
Name:IMBO, HONEY RIZZA ANG (LCSW)
Entity type:Individual
Prefix:
First Name:HONEY RIZZA
Middle Name:ANG
Last Name:IMBO
Suffix:
Gender:F
Credentials:LCSW
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 6630
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96931-6630
Mailing Address - Country:US
Mailing Address - Phone:671-483-1546
Mailing Address - Fax:
Practice Address - Street 1:215 E CHALAN SANTO PAPA STE 109F
Practice Address - Street 2:
Practice Address - City:HAGATNA
Practice Address - State:GU
Practice Address - Zip Code:96910-5203
Practice Address - Country:US
Practice Address - Phone:671-483-1546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GULCSW-E-0321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical