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General NPI Number Information
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NPI Number | 1568704351
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Entity Type | Individual
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Provider Name | VISHWANI SHIRVANA RAM-SOUZA LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 54 KAIKUONO ST
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City | HILO
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State | HI
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Zip | 96720-1730
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Country | US
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Telephone | 612-644-0737
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Fax |
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Provider Business Mailing Address
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Address Line | 54 KAIKUONO ST
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City | HILO
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State | HI
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Zip | 96720-1730
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Country | US
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Telephone | 612-644-0737
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 438
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | MN
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