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General NPI Number Information
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NPI Number | 1932869088
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Entity Type | Organization
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Legal Business Name | SYMBIOSIS INC
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Dates
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Enumeration Date | 12/29/2021
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 65-1231 OPELO RD STE 7
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City | KAMUELA
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State | HI
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Zip | 96743-8376
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Country | US
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Telephone | 808-640-1968
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Fax |
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Provider Business Mailing Address
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Address Line | 65-1231 OPELO RD STE 7
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City | KAMUELA
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State | HI
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Zip | 96743-8376
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Country | US
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Telephone | 808-640-1968
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Fax | 808-775-9586
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. JAMUNA WYSS
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Credential | PSY. D.
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Telephone | 808-640-1968
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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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