Provider Demographics
NPI:1649483389
Name:DEMANDEL-SCHALLER, LAURETTE (MFT, SAP, PHD)
Entity type:Individual
Prefix:DR
First Name:LAURETTE
Middle Name:
Last Name:DEMANDEL-SCHALLER
Suffix:
Gender:F
Credentials:MFT, SAP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1071
Mailing Address - Street 2:
Mailing Address - City:HANALEI
Mailing Address - State:HI
Mailing Address - Zip Code:96714-1071
Mailing Address - Country:US
Mailing Address - Phone:808-826-1490
Mailing Address - Fax:808-826-9697
Practice Address - Street 1:2975 HALEKO RD
Practice Address - Street 2:SUITE 307
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766
Practice Address - Country:US
Practice Address - Phone:808-826-1490
Practice Address - Fax:808-826-9697
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15106H00000X
CAMFC22146106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist