KA IMI PONO, LLC

HONOLULU, HI
NPI1083891469
Entity TypeOrganization
Authorized ContactGAIL LYNN TICE
Clinical Psychologist
808-387-5307
Organization Subpart ?No
Primary Taxonomy103TC0700X Psychologist Clinical
(Licence: HI  899)
Enumeration Date2008-01-28
Last Update Date2008-01-28
Business Address
KA IMI PONO, LLC
1029 KAPAHULU AVE STE 405
HONOLULU, HI 96816-1332
Phone number: 808-387-5307
Mailing Address
KA IMI PONO, LLC
PO BOX 161191
HONOLULU, HI 96816-0925
Phone number: 808-387-5307