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General NPI Number Information
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NPI Number | 1821552472
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Entity Type | Individual
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Provider Name | EMILYANN ROSE SHUPE MSCP, LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 438 HOBRON LN STE 405
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City | HONOLULU
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State | HI
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Zip | 96815-1229
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Country | US
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Telephone | 808-941-9648
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Fax |
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Provider Business Mailing Address
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Address Line | 509 UNIVERSITY AVE APT 701
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City | HONOLULU
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State | HI
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Zip | 96826-5008
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Country | US
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Telephone | 818-219-8209
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 548
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License Number State | HI
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