| NPI | 1083891469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL LYNN TICE Clinical Psychologist 808-387-5307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: HI 899) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-28 |