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General NPI Number Information
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NPI Number | 1871674465
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Entity Type | Individual
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Provider Name | MARK DANIEL DICHNER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 91-1009 KAIMOANA ST
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City | EWA BEACH
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State | HI
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Zip | 96706-6071
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Country | US
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Telephone | 808-689-8811
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Fax | 808-689-0316
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Provider Business Mailing Address
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Address Line | 91-1009 KAIMOANA ST
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City | EWA BEACH
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State | HI
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Zip | 96706-6071
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Country | US
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Telephone | 808-689-8811
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Fax | 808-689-8811
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY315
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 315
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License Number State | HI
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