Provider Demographics
NPI:1720236961
Name:REYES, LEIANA MARIE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LEIANA
Middle Name:MARIE
Last Name:REYES
Suffix:
Gender:F
Credentials:LMFT
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 4443
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-0443
Mailing Address - Country:US
Mailing Address - Phone:808-937-4363
Mailing Address - Fax:808-966-4689
Practice Address - Street 1:101 AUPUNI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4246
Practice Address - Country:US
Practice Address - Phone:808-937-4363
Practice Address - Fax:808-966-4689
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI306106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist