| Rosary Nancy Moreno-derks | |
|
77-255 Holomakani Street Kailua Kona HI 96740 | |
| (760) 554-4395 | |
| Not Available |
| Full Name | Rosary Nancy Moreno-derks |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 77-255 Holomakani Street, Kailua Kona, Hawaii |
| Authorized Official Name and Position | Rosary Nancy Moreno-derks (PRESIDENT) |
| Authorized Official Contact | 7605544395 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosary Nancy Moreno-derks 77-255 Holomakani Street Kailua Kona HI 96740 Ph: (760) 554-4395 | Rosary Nancy Moreno-derks 77-255 Holomakani Street Kailua Kona HI 96740 Ph: (760) 554-4395 |
| NPI Number | 1427340058 |
|---|---|
| Provider Enumeration Date | 05/16/2011 |
| Last Update Date | 05/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427340058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | MFC 15988 (California) | Secondary |
| 106H00000X | Marriage & Family Therapist | MFC 15988 (California) | Primary |
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