Provider Demographics
NPI:1649933284
Name:SAELUA, MAINA TAEAFA (COHC)
Entity type:Individual
Prefix:MR
First Name:MAINA
Middle Name:TAEAFA
Last Name:SAELUA
Suffix:
Gender:M
Credentials:COHC
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 1179
Mailing Address - Street 2:
Mailing Address - City:PAGO PAGO
Mailing Address - State:AS
Mailing Address - Zip Code:96799-1179
Mailing Address - Country:US
Mailing Address - Phone:684-252-4038
Mailing Address - Fax:
Practice Address - Street 1:LBJ TROPICAL MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:FAGAALU RD
Practice Address - State:AS
Practice Address - Zip Code:96799
Practice Address - Country:US
Practice Address - Phone:684-633-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant