Healthcare Provider Details

I. General information

NPI: 1235517350
Provider Name (Legal Business Name): MARY MYERS PHD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 12/31/2023
Certification Date: 12/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 BISHOP ST STE 3512
HONOLULU HI
96813-3314
US

IV. Provider business mailing address

1188 BISHOP ST STE 3512
HONOLULU HI
96813-3314
US

V. Phone/Fax

Practice location:
  • Phone: 808-550-0991
  • Fax: 808-550-0992
Mailing address:
  • Phone: 808-550-0991
  • Fax: 808-550-0992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MARY K MYERS
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 808-550-0991