| NPI | 1043859200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ELIZABETH-ROSE CARROLL Clinical Psychologist 808-345-4863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-01-05 |
| Last Update Date | 2020-01-05 |