Healthcare Provider Details

I. General information

NPI: 1831463769
Provider Name (Legal Business Name): WHITNEY LYN HEYD LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2012
Last Update Date: 02/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 KUWILI ST ROOM 105
HONOLULU HI
96817-5362
US

IV. Provider business mailing address

414 KUWILI ST ROOM 105
HONOLULU HI
96817-5362
US

V. Phone/Fax

Practice location:
  • Phone: 808-532-6744
  • Fax: 808-532-6747
Mailing address:
  • Phone: 808-532-6744
  • Fax: 808-532-6747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1800
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: