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General NPI Number Information
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NPI Number | 1225804909
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Entity Type | Organization
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Legal Business Name | HANNAH IM, LLC
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 1164 BISHOP ST STE 929
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City | HONOLULU
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State | HI
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Zip | 96813-2882
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Country | US
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Telephone | 808-773-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 927 PROSPECT ST APT 203
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City | HONOLULU
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State | HI
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Zip | 96822-3415
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Country | US
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Telephone | 808-773-4400
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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. HANNAH IM
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Credential | PSYD
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Telephone | 808-773-4400
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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 |
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License Number State |
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