Provider Demographics
NPI:1922373620
Name:LAVE, SHAVONE MARIE KAWAILANI (MA)
Entity type:Individual
Prefix:MRS
First Name:SHAVONE
Middle Name:MARIE KAWAILANI
Last Name:LAVE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87-153 LAIKU ST
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3689
Mailing Address - Country:US
Mailing Address - Phone:808-282-3272
Mailing Address - Fax:
Practice Address - Street 1:87-153 LAIKU ST
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-3689
Practice Address - Country:US
Practice Address - Phone:808-282-3272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health