Healthcare Provider Details

I. General information

NPI: 1861544025
Provider Name (Legal Business Name): MARIA BRIONES PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3176 POIPU RD STE 5
KOLOA HI
96756-9521
US

IV. Provider business mailing address

5473 PUULIMA RD # C
KALAHEO HI
96741-9301
US

V. Phone/Fax

Practice location:
  • Phone: 808-742-6446
  • Fax:
Mailing address:
  • Phone: 808-742-6446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY-673
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: