| NPI | 1770074031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIA CLAYPOOL Clinical Director 808-499-8939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X (Licence: HI 483) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2018-05-22 |