Provider Demographics
NPI:1447011853
Name:KANAMU07, LIANA LEIMOMILANI
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:LEIMOMILANI
Last Name:KANAMU07
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 1:1080 EHA ST APT 105
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2086
Mailing Address - Country:US
Mailing Address - Phone:808-666-1830
Mailing Address - Fax:
Practice Address - Street 1:1080 EHA ST APT 105
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2086
Practice Address - Country:US
Practice Address - Phone:808-666-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician