Healthcare Provider Details

I. General information

NPI: 1760909709
Provider Name (Legal Business Name): ELIZABETH M H TESCHNER PHD LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4886 KAWAIHAU RD RM A30
KAPAA HI
96746-1930
US

IV. Provider business mailing address

PO BOX 449
ANAHOLA HI
96703-0449
US

V. Phone/Fax

Practice location:
  • Phone: 808-821-6972
  • Fax:
Mailing address:
  • Phone: 218-213-8282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1664
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1664
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: