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General NPI Number Information
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NPI Number | 1053436642
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Entity Type | Organization
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Legal Business Name | LIVING WELL INC.
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 98-084 KAMEHAMEHA HWY SUITE 304
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City | AIEA
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State | HI
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Zip | 96701-5122
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Country | US
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Telephone | 808-486-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 98-084 KAMEHAMEHA HWY SUITE 404
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City | AIEA
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State | HI
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Zip | 96701-5122
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Country | US
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Telephone | 808-486-1020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT DIRECTOR
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Name | DR. CHRISTINA CATHERINE KENT
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Credential | PSYD.
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Telephone | 808-486-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 794
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License Number State | HI
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