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General NPI Number Information
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NPI Number | 1235517350
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Entity Type | Organization
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Legal Business Name | MARY MYERS PHD INC
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Dates
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Enumeration Date | 05/08/2015
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Last Update Date | 12/31/2023
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Provider Practice Location Address
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Address Line | 1188 BISHOP ST STE 3512
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City | HONOLULU
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State | HI
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Zip | 96813-3314
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Country | US
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Telephone | 808-550-0991
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Fax | 808-550-0992
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Provider Business Mailing Address
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Address Line | 1188 BISHOP ST STE 3512
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City | HONOLULU
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State | HI
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Zip | 96813-3314
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Country | US
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Telephone | 808-550-0991
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Fax | 808-550-0992
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | MARY K MYERS
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Credential | PHD
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Telephone | 808-550-0991
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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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