Provider Demographics
NPI:1679898571
Name:GUGGENHEIM, DANA MICHELLE (LAC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MICHELLE
Last Name:GUGGENHEIM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66216 FARRINGTON HWY. STE 202
Mailing Address - Street 2:
Mailing Address - City:WAIALUA
Mailing Address - State:HI
Mailing Address - Zip Code:96791
Mailing Address - Country:US
Mailing Address - Phone:808-637-4880
Mailing Address - Fax:808-637-4880
Practice Address - Street 1:67-216 FARRINGTON HWY STE 202
Practice Address - Street 2:
Practice Address - City:WAIALUA
Practice Address - State:HI
Practice Address - Zip Code:96791-9671
Practice Address - Country:US
Practice Address - Phone:808-637-4880
Practice Address - Fax:808-637-4880
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI908171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist