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General NPI Number Information
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NPI Number | 1275292237
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Entity Type | Organization
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Legal Business Name | BODY MIND THERAPY INC
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Dates
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Enumeration Date | 12/16/2021
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 1314 S KING ST STE 1552
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City | HONOLULU
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State | HI
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Zip | 96814-1949
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Country | US
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Telephone | 808-457-2669
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Fax | 808-689-8244
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Provider Business Mailing Address
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Address Line | 1314 S KING ST STE 1552
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City | HONOLULU
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State | HI
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Zip | 96814-1949
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Country | US
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Telephone | 808-457-2669
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Fax | 808-689-8244
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Authorized Official
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Title or Position | PRESIDENT
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Name | YASUKO AKIYAMA-BEVETT
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Credential | MHC
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Telephone | 808-457-2669
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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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