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General NPI Number Information
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NPI Number | 1285854646
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Entity Type | Individual
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Provider Name | TRINA NAHM-MIJO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17-4205 13 MILE ROAD
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City | KURTISTOWN
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State | HI
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Zip | 96760
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Country | US
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Telephone | 808-966-7154
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Fax | 808-974-7757
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Provider Business Mailing Address
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Address Line | PO BOX 304
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City | KURTISTOWN
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State | HI
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Zip | 96760-0304
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Country | US
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Telephone | 808-966-7154
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Fax | 808-974-7757
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 33
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License Number State | HI
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