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General NPI Number Information
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NPI Number | 1023246790
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Entity Type | Organization
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Legal Business Name | INTEGRATED MENTAL HEALTH SERVICE INC
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 1847 S KIHEI RD STE 205
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City | KIHEI
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State | HI
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Zip | 96753-7939
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Country | US
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Telephone | 808-280-2067
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 958
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City | KIHEI
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State | HI
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Zip | 96753-0958
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Country | US
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Telephone | 808-280-2067
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHERI EWING
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Credential |
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Telephone | 808-280-2067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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