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General NPI Number Information
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NPI Number | 1518054972
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Entity Type | Individual
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Provider Name | THERESIA WALTRAUD PRESBREY PHD
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 AUPUNI ST SUITE 240
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City | HILO
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State | HI
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Zip | 96720-4262
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Country | US
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Telephone | 808-935-3395
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Fax | 808-969-6843
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Provider Business Mailing Address
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Address Line | 101 AUPUNI ST SUITE 240
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City | HILO
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State | HI
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Zip | 96720-4262
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Country | US
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Telephone | 808-935-3395
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Fax | 808-969-6843
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY317
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License Number State | HI
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