Provider Demographics
NPI:1063684751
Name:VARHOLICK, LOUANNE MARIE ALONZO (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOUANNE
Middle Name:MARIE ALONZO
Last Name:VARHOLICK
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:PO BOX 600
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-0600
Mailing Address - Country:US
Mailing Address - Phone:808-639-9927
Mailing Address - Fax:
Practice Address - Street 1:216B LULO RD
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-3207
Practice Address - Country:US
Practice Address - Phone:808-639-9927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1031103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist