Provider Demographics
NPI:1144466509
Name:LAU, EARL K (MA, MFT)
Entity type:Individual
Prefix:MR
First Name:EARL
Middle Name:K
Last Name:LAU
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46-401 HAIKU RD
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3558
Mailing Address - Country:US
Mailing Address - Phone:808-391-2289
Mailing Address - Fax:
Practice Address - Street 1:319 N CANE ST STE A
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2130
Practice Address - Country:US
Practice Address - Phone:808-391-2289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI204106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist