Healthcare Provider Details

I. General information

NPI: 1508154113
Provider Name (Legal Business Name): OHANA PSYCHOLOGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2011
Last Update Date: 08/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 S KING ST SUITE 864
HONOLULU HI
96814-1956
US

IV. Provider business mailing address

1314 S KING ST STE 864
HONOLULU HI
96814-1943
US

V. Phone/Fax

Practice location:
  • Phone: 808-596-8899
  • Fax:
Mailing address:
  • Phone: 808-596-8899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 1266
License Number StateHI

VIII. Authorized Official

Name: DR. WILLIAM J MARKS
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 808-596-8899