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NPI Code Detail

MEDICARE: DR. MARVIN WILSON ACKLIN PH.D.

MEDICARE:  DR. MARVIN WILSON ACKLIN  PH.D.
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
1103TC0700XClinical Psychologist394HI

General Provider Information

NPI Number : 1902961840
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARVIN WILSON ACKLIN PH.D.
Provider Business Mailing Address
First Line : 850 W. HIND DRIVE
Second Line : SUITE 203
City : HONOLULU
State : HI
Zip : 96821-1845
Country : US
Telephone Number : 808-373-3880
Fax Number : 808-373-1158
Provider Business Practice Location Address
First Line : 850 W. HIND DRIVE
Second Line : SUITE 203
City : HONOLULU
State : HI
Zip : 96821-1845
Country : US
Telephone Number : 808-373-3880
Fax Number : 808-373-1158
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MARVIN WILSON ACKLIN PH.D.” Practice Location

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