Healthcare Provider Details

I. General information

NPI: 1831865179
Provider Name (Legal Business Name): BRITTNEY J KEITH PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 MAUNALOA HWY. BLDG C
KAUNAKAKAI HI
96748
US

IV. Provider business mailing address

PO BOX 130
KAUNAKAKAI HI
96748-0130
US

V. Phone/Fax

Practice location:
  • Phone: 808-560-3653
  • Fax: 808-560-3385
Mailing address:
  • Phone: 808-560-3653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-1922
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: