Healthcare Provider Details

I. General information

NPI: 1447926456
Provider Name (Legal Business Name): FLYING WITH EAGLES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BISHOP STREET, ASB TOWER SUITE 1542
HONOLULU HI
96813-9681
US

IV. Provider business mailing address

1001 BISHOP STREET, ASB TOWER SUITE 1542
HONOLULU HI
96813
US

V. Phone/Fax

Practice location:
  • Phone: 808-783-7527
  • Fax:
Mailing address:
  • Phone: 808-783-7527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DAVID L. BEVETT
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 808-783-7527