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General NPI Number Information
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NPI Number | 1730846247
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Entity Type | Organization
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Legal Business Name | TRYSHA LM BODDEN, LMFT, LLC
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 1130 N NIMITZ HWY RM A203
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City | HONOLULU
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State | HI
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Zip | 96817-5785
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Country | US
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Telephone | 808-294-5810
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Fax |
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Provider Business Mailing Address
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Address Line | 91-2032 KAIOLI ST APT 6001
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City | EWA BEACH
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State | HI
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Zip | 96706-6081
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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 | LMFT, OWNER
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Name | TRYSHA BODDEN
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Credential | MA
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Telephone | 808-294-5810
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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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