Doctor Name: | MRS. JENNIFER PURCELL |
NPI Number: | 1184094823 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMFT |
License Number: | 1727 |
Business Practice Address: | 1135 Makawao Ave Ste 102 Makawao, HI - 967687401 |
Business Phone Number: | 8082147307 |
Business Fax Number: | 8085736091 |
Mailing Address: | Po Box 1723, MAKAWAO |
State: | HI |
Postal Code: | 967681723 |
Phone Number: | 8082147307 |
Fax Number: | 8085736091 |
NPI Enumeration Date: | 10/06/2015 |
NPI Last Update Date: | 10/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1727 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | HI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |