Provider Demographics
NPI:1912652660
Name:BURRELL, ZOE KA'IULANI
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:KA'IULANI
Last Name:BURRELL
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 1:2889 ALA ILIMA ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-1704
Mailing Address - Country:US
Mailing Address - Phone:702-524-6212
Mailing Address - Fax:
Practice Address - Street 1:2889 ALA ILIMA ST APT 5A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-1704
Practice Address - Country:US
Practice Address - Phone:702-524-6212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician