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General NPI Number Information
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NPI Number | 1801657473
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Entity Type | Organization
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Legal Business Name | DR. MELISSA VARGO LLC
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 354 ULUNIU ST STE 404A
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City | KAILUA
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State | HI
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Zip | 96734-2533
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Country | US
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Telephone | 808-626-5006
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Fax |
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Provider Business Mailing Address
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Address Line | 575 N KALAHEO AVE
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City | KAILUA
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State | HI
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Zip | 96734-2114
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Country | US
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Telephone | 808-626-5006
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. MELISSA VARGO
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Credential | PSY.D
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Telephone | 808-457-0872
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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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