Provider Demographics
NPI:1043510191
Name:GUIDICI, DIANE K (MFT, MIN)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:K
Last Name:GUIDICI
Suffix:
Gender:F
Credentials:MFT, MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 NANA PL # 1
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1369
Mailing Address - Country:US
Mailing Address - Phone:808-821-1940
Mailing Address - Fax:
Practice Address - Street 1:341 NANA PL # 1
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1369
Practice Address - Country:US
Practice Address - Phone:808-821-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 21066106H00000X
HIHI 2012-02432101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist