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General NPI Number Information
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NPI Number | 1447289194
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Entity Type | Individual
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Provider Name | LOUISE M. LETTICH M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 755 SCOTT CIR
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City | JBPHH
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State | HI
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Zip | 96853-5399
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Country | US
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Telephone | 808-448-6377
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Fax | 866-269-3450
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Provider Business Mailing Address
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Address Line | 361 KAILUA RD APT 8208
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City | KAILUA
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State | HI
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Zip | 96734-2965
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Country | US
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Telephone | 808-429-2581
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 51779
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD8579
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License Number State | HI
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