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General NPI Number Information
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NPI Number | 1407579303
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Entity Type | Organization
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Legal Business Name | HEALTHY MIND LLC
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 94-210 PUPUKAHI ST STE 207
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City | WAIPAHU
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State | HI
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Zip | 96797-2649
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Country | US
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Telephone | 808-382-6816
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2224
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City | EWA BEACH
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State | HI
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Zip | 96706-0224
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Country | US
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Telephone | 808-382-6816
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. AGNES FELIX
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Credential | PHD
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Telephone | 808-382-6816
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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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