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General NPI Number Information
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NPI Number | 1679272850
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Entity Type | Organization
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Legal Business Name | THE CONSCIOUS MIND THERAPY LLC
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 3726 CRATER RD APT A
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City | HONOLULU
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State | HI
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Zip | 96816-2346
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Country | US
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Telephone | 808-389-8858
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 283029
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City | HONOLULU
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State | HI
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Zip | 96828-3029
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Country | US
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Telephone | 808-389-8858
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE FAMILY THERAPIST
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Name | KRISTEN CANENCIA
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Credential | LMFT
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Telephone | 808-389-8858
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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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