Healthcare Provider Details

I. General information

NPI: 1467625582
Provider Name (Legal Business Name): ANTHONY SCOTT ALLRED
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45-021 LIKEKE PL
KANEOHE HI
96744-2426
US

IV. Provider business mailing address

54-018 HAUKOI PL
HAUULA HI
96717-9529
US

V. Phone/Fax

Practice location:
  • Phone: 808-236-2288
  • Fax: 808-247-4032
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: