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General NPI Number Information
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NPI Number | 1750090452
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Entity Type | Individual
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Provider Name | CARMEN NICOLE GONOWON PSYD
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Gender | Female
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 1188 BISHOP ST STE 1007
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City | HONOLULU
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State | HI
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Zip | 96813-3304
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Country | US
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Telephone | 808-913-4184
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 NUUANU AVE APT 2708
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City | HONOLULU
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State | HI
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Zip | 96817-4031
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Country | US
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Telephone | 217-766-9492
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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