Healthcare Provider Details

I. General information

NPI: 1558034686
Provider Name (Legal Business Name): AMY ELIZABETH HUFSTEDLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 PATTERSON RD
HONOLULU HI
96819-1522
US

IV. Provider business mailing address

520 N MARTIN ST
LITTLE ROCK AR
72205-4118
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-0600
  • Fax:
Mailing address:
  • Phone: 501-944-1033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2230
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: