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General NPI Number Information
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NPI Number | 1174148977
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Entity Type | Organization
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Legal Business Name | JAMIE R. HORTON PHD LLC
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 06/08/2020
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Provider Practice Location Address
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Address Line | 1110 UNIVERSITY AVE STE 205
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City | HONOLULU
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State | HI
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Zip | 96826-1598
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Country | US
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Telephone | 808-282-5874
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Fax | 888-377-9159
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Provider Business Mailing Address
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Address Line | 1330 WILDER AVE APT 314
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City | HONOLULU
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State | HI
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Zip | 96822-4272
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Country | US
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Telephone | 808-282-5874
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Fax | 888-377-9159
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Authorized Official
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Title or Position | SINGLE MEMBER LLC OWNER
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Name | DR. JAMIE RONNEE HORTON GIGANTE
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Credential | PHD
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Telephone | 808-282-5874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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