Healthcare Provider Details

I. General information

NPI: 1811291107
Provider Name (Legal Business Name): MADELYN M. BRUNO MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2010
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65-1279 KAWAIHAE RD
KAMUELA HI
96743-8444
US

IV. Provider business mailing address

PO BOX 1551
KAMUELA HI
96743-1551
US

V. Phone/Fax

Practice location:
  • Phone: 808-885-5050
  • Fax: 808-885-5055
Mailing address:
  • Phone: 808-937-9699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT - 262
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: