Healthcare Provider Details

I. General information

NPI: 1154310639
Provider Name (Legal Business Name): ROBIN B WELCH PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 PIIKOI ST SUITE 1603
HONOLULU HI
96814-3116
US

IV. Provider business mailing address

615 PIIKOI ST SUITE 1603
HONOLULU HI
96814-3116
US

V. Phone/Fax

Practice location:
  • Phone: 808-596-8778
  • Fax: 808-596-8558
Mailing address:
  • Phone: 808-596-8778
  • Fax: 808-596-8558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY598
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: