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General NPI Number Information
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NPI Number | 1558936781
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Entity Type | Organization
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Legal Business Name | PLAY THERAPY MAUI LLC
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 2200 MAIN ST STE 518
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City | WAILUKU
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State | HI
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Zip | 96793-1624
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Country | US
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Telephone | 808-359-8290
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 427
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City | WAILUKU
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State | HI
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Zip | 96793-0427
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAYNA S HORIE
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Credential | LMFT
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Telephone | 808-222-6263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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