Provider Demographics
NPI:1528764321
Name:FARIAS, DORY ANN KALEOLOILANI
Entity type:Individual
Prefix:
First Name:DORY ANN
Middle Name:KALEOLOILANI
Last Name:FARIAS
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 1:2970 KELE ST STE 203
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1803
Mailing Address - Country:US
Mailing Address - Phone:808-821-2520
Mailing Address - Fax:
Practice Address - Street 1:2970 KELE ST STE 203
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1803
Practice Address - Country:US
Practice Address - Phone:808-821-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator