| NPI | 1902115082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DOUGLAS BREITHAUPT Licensed Clinical Psychologist 808-205-8403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: HI PSY499) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2025-05-19 |