MEDICARE: DR. SHEILA MOANA MARIE ALEXANDER BART PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1133	HI

General Provider Information

NPI Number	:	1124156278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEILA MOANA MARIE ALEXANDER BART PSY.D.

Provider Business Mailing Address
First Line	:	PO BOX 29282
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96820-1682
Country	:	US
Telephone Number	:	808-387-8812
Fax Number	:

Provider Business Practice Location Address
First Line	:	3375 KOAPAKA ST.
Second Line	:	SUITE C315
City	:	HONOLULU
State	:	HI
Zip	:	96819-1862
Country	:	US
Telephone Number	:	808-387-8812
Fax Number	:	808-744-3099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	03/02/2011

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