Provider Demographics
NPI:1023364213
Name:FLAVIN, ADRIANNA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANNA
Middle Name:MARIE
Last Name:FLAVIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 ULUNUI PL
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8523
Mailing Address - Country:US
Mailing Address - Phone:808-446-5545
Mailing Address - Fax:
Practice Address - Street 1:7 AEWA PLACE
Practice Address - Street 2:UNIT 7-A
Practice Address - City:PUKALANI
Practice Address - State:HI
Practice Address - Zip Code:96768
Practice Address - Country:US
Practice Address - Phone:808-446-5545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY1449103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical