MEDICARE: DR. HSIN-TINE TINA LIU-TOM PH.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	103TC1900X	Counseling Psychologist	PSY-813	HI

General Provider Information

NPI Number	:	1497701007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HSIN-TINE TINA LIU-TOM PH.D.

Provider Business Mailing Address
First Line	:	1188 BISHOP ST
Second Line	:	SUITE 2907
City	:	HONOLULU
State	:	HI
Zip	:	96813-3301
Country	:	US
Telephone Number	:	808-781-5607
Fax Number	:	808-536-4668

Provider Business Practice Location Address
First Line	:	1188 BISHOP ST
Second Line	:	SUITE 2907
City	:	HONOLULU
State	:	HI
Zip	:	96813-3301
Country	:	US
Telephone Number	:	808-781-5607
Fax Number	:	808-536-4668

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/09/2007

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