Provider Demographics
NPI:1932837820
Name:LOVELL-WONG, KUULEIALOHA
Entity type:Individual
Prefix:
First Name:KUULEIALOHA
Middle Name:
Last Name:LOVELL-WONG
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:PO BOX 267
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:HI
Mailing Address - Zip Code:96771-0267
Mailing Address - Country:US
Mailing Address - Phone:808-464-9604
Mailing Address - Fax:
Practice Address - Street 1:18-4200 HENO ST.
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:HI
Practice Address - Zip Code:96771
Practice Address - Country:US
Practice Address - Phone:808-464-9604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician