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General NPI Number Information
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NPI Number | 1871251488
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Entity Type | Organization
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Legal Business Name | DEVON MASUDA, PSY D LLC
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 820 HELE MAUNA ST
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City | HILO
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State | HI
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Zip | 96720-1752
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Country | US
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Telephone | 808-825-8275
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7685
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City | HILO
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State | HI
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Zip | 96720-8949
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Country | US
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Telephone | 808-825-8275
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Fax | 844-807-9181
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. DEVON MASUDA
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Credential | PSY.D.
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Telephone | 808-825-8275
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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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