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General NPI Number Information
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NPI Number | 1265709356
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Entity Type | Organization
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Legal Business Name | THERAPY4POSITIVECHANGES LLC
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 12/12/2011
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Provider Practice Location Address
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Address Line | 615 PIIKOI ST SUITE 511
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City | HONOLULU
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State | HI
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Zip | 96814
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Country | US
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Telephone | 808-728-8533
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Fax | 855-343-8826
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Provider Business Mailing Address
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Address Line | 615 PIIKOI ST SUITE 511
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City | HONOLULU
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State | HI
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Zip | 96814
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Country | US
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Telephone | 808-278-4533
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Fax | 855-343-8826
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Authorized Official
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Title or Position | CEO
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Name | DR. THOMAS WELTER PAUL WELTER
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Credential | PHD
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Telephone | 808-728-8533
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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 | 1217
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License Number State | HI
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