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General NPI Number Information
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NPI Number | 1669647244
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Entity Type | Organization
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Legal Business Name | CONSULTING NEUROPSYCHOLOGY SERVICES LLC
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 4566 OHIA ST STE 3
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City | KAPAA
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State | HI
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Zip | 96746-1646
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Country | US
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Telephone | 808-639-9927
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 600
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City | KAPAA
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State | HI
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Zip | 96746-0600
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Country | US
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Telephone | 808-639-9927
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LOUANNE LISK
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Credential |
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Telephone | 808-639-9927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 1031
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License Number State | HI
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