Healthcare Provider Details

I. General information

NPI: 1417225236
Provider Name (Legal Business Name): MOLLY LYTTON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2011
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 PIIKOI ST STE 1406
HONOLULU HI
96814-3141
US

IV. Provider business mailing address

615 PIIKOI ST STE 1406
HONOLULU HI
96814-3141
US

V. Phone/Fax

Practice location:
  • Phone: 808-369-3823
  • Fax:
Mailing address:
  • Phone: 808-253-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT 17447
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT 92
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: