MEDICARE: SHAWNA LEDWARD PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY-860	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356380810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWNA LEDWARD PSYD

Provider Business Mailing Address
First Line	:	91-3575 KAULUAKOKO UNIT 1108
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-5856
Country	:	US
Telephone Number	:	808-204-0495
Fax Number	:	808-439-6869

Provider Business Practice Location Address
First Line	:	91-3575 KAULUAKOKO UNIT 1108
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-5856
Country	:	US
Telephone Number	:	808-294-0495
Fax Number	:	808-439-6869

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	04/06/2021

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Directions to “ SHAWNA LEDWARD PSYD” Practice Location

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