Healthcare Provider Details

I. General information

NPI: 1811564800
Provider Name (Legal Business Name): HAWAII NEUROPSYCHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 BISHOP ST STE 2700
HONOLULU HI
96813-6475
US

IV. Provider business mailing address

1905 PIIMAUNA PL
HONOLULU HI
96821-2615
US

V. Phone/Fax

Practice location:
  • Phone: 808-670-8668
  • Fax: 808-207-6841
Mailing address:
  • Phone: 808-670-8668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. RACHEL SONG
Title or Position: DIRECTOR
Credential: PH.D
Phone: 808-670-8668