Healthcare Provider Details

I. General information

NPI: 1962427740
Provider Name (Legal Business Name): TERRY SUE BEURET PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 LEHUA AVE
PEARL CITY HI
96782-3328
US

IV. Provider business mailing address

9340 NE 76TH ST
VANCOUVER WA
98662-3721
US

V. Phone/Fax

Practice location:
  • Phone: 808-453-1919
  • Fax:
Mailing address:
  • Phone: 808-236-2260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 727
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: