MEDICARE: JEAN ADAIR-LELAND 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	103TC0700X	Clinical Psychologist	220	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952341224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN ADAIR-LELAND PH.D.

Provider Business Mailing Address
First Line	:	1484 HIIKALA PLACE
Second Line	:	#13
City	:	HONOLULU
State	:	HI
Zip	:	96816-5633
Country	:	US
Telephone Number	:	808-384-5172
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 WAIALAE AVE
Second Line	:	STE. 206B
City	:	HONOLULU
State	:	HI
Zip	:	96816-5319
Country	:	US
Telephone Number	:	808-739-6224
Fax Number	:

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	12/05/2008

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