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General NPI Number Information
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NPI Number | 1851703607
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Entity Type | Organization
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Legal Business Name | ELIZABETH KEOLANI TAITANO, PH.D., LLC
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 40 AULIKE ST SUITE 411
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City | KAILUA
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State | HI
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Zip | 96734-2758
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Country | US
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Telephone | 808-341-4328
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Fax | 877-348-8227
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Provider Business Mailing Address
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Address Line | PO BOX 884
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City | KAILUA
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State | HI
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Zip | 96734-0884
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Country | US
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Telephone | 808-341-4328
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Fax | 877-348-8227
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELIZABETH KEOLANI TAITANO
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Credential | PH.D.
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Telephone | 808-341-4328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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