Provider Demographics
NPI:1588402325
Name:AGUILAR, WILLSON ABRAHAM (BACHELORS DEGREE)
Entity type:Individual
Prefix:
First Name:WILLSON
Middle Name:ABRAHAM
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:BACHELORS DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87-392 MANUAIHUE ST
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-5200
Mailing Address - Country:US
Mailing Address - Phone:323-403-9312
Mailing Address - Fax:323-403-9312
Practice Address - Street 1:85-888 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2403
Practice Address - Country:US
Practice Address - Phone:808-696-9498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor