Healthcare Provider Details

I. General information

NPI: 1497701007
Provider Name (Legal Business Name): HSIN-TINE TINA LIU-TOM PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: HSIN-TINE TINA LIU PH.D.

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 BISHOP ST SUITE 2907
HONOLULU HI
96813-3301
US

IV. Provider business mailing address

1188 BISHOP ST SUITE 2907
HONOLULU HI
96813-3301
US

V. Phone/Fax

Practice location:
  • Phone: 808-781-5607
  • Fax: 808-536-4668
Mailing address:
  • Phone: 808-781-5607
  • Fax: 808-536-4668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY-813
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: