| NPI | 1629640859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTEL FERNANDEZ LOPEZ Psychologist 808-681-2309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC0700X Psychologist Clinical | |
| 103TF0000X Psychologist Family | |
| 103TP2701X Psychologist Group Psychotherapy | |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2021-07-16 |