Provider Demographics
NPI:1992442578
Name:DEVRIES, MACAELE DIANE (MA, MS)
Entity type:Individual
Prefix:MS
First Name:MACAELE
Middle Name:DIANE
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:MA, MS
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Other - Credentials:
Mailing Address - Street 1:91-2128 OLD FT WEAVER ROAD
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1911
Mailing Address - Country:US
Mailing Address - Phone:808-589-1829
Mailing Address - Fax:808-589-2610
Practice Address - Street 1:91-2128 OLD FT WEAVER ROAD
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1911
Practice Address - Country:US
Practice Address - Phone:808-589-1829
Practice Address - Fax:808-589-2610
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health