Healthcare Provider Details

I. General information

NPI: 1861185977
Provider Name (Legal Business Name): MINDFUL CONNECTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HEKILI ST STE A124
KAILUA HI
96734-2800
US

IV. Provider business mailing address

111 HEKILI ST STE A124
KAILUA HI
96734-2800
US

V. Phone/Fax

Practice location:
  • Phone: 808-427-4750
  • Fax:
Mailing address:
  • Phone: 808-427-4750
  • 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. GABRIELLE TOLOZA
Title or Position: PROVIDER
Credential: MD
Phone: 808-427-4750