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General NPI Number Information
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NPI Number | 1992980056
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Entity Type | Organization
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Legal Business Name | L. MAILE LABASAN, PH.D., INC.
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 1600 KAPIOLANI BLVD SUITE 1306
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City | HONOLULU
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State | HI
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Zip | 96814-3801
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Country | US
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Telephone | 808-949-7444
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 KAPIOLANI BLVD SUITE 1306
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City | HONOLULU
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State | HI
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Zip | 96814-3801
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Country | US
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Telephone | 808-949-7444
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. LYNETTE MAILE LABASAN
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Credential | PH.D.
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Telephone | 808-949-7444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY759
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License Number State | HI
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