Provider Demographics
NPI:1093031262
Name:PERREIRA, TAMMIE NOELANI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TAMMIE
Middle Name:NOELANI
Last Name:PERREIRA
Suffix:
Gender:F
Credentials:PSYD
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 810
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-0810
Mailing Address - Country:US
Mailing Address - Phone:808-542-5624
Mailing Address - Fax:
Practice Address - Street 1:41-1610 KALANIANAOLE HWY STE 104
Practice Address - Street 2:
Practice Address - City:WAIMANALO
Practice Address - State:HI
Practice Address - Zip Code:96795-1190
Practice Address - Country:US
Practice Address - Phone:808-542-5624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-13
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1178103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical