Provider Demographics
NPI:1144618463
Name:DAVID L. NASH, PHD
Entity Type:Organization
Organization Name:DAVID L. NASH, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-623-6375
Mailing Address - Street 1:95-1249 MEHEULA PKWY
Mailing Address - Street 2:#195
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1779
Mailing Address - Country:US
Mailing Address - Phone:808-623-6375
Mailing Address - Fax:808-623-6585
Practice Address - Street 1:95-1249 MEHEULA PKWY
Practice Address - Street 2:#195
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1779
Practice Address - Country:US
Practice Address - Phone:808-623-6375
Practice Address - Fax:808-623-6585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-741103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty