Provider Demographics
NPI:1235517350
Name:MARY MYERS PHD INC
Entity Type:Organization
Organization Name:MARY MYERS PHD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-550-0991
Mailing Address - Street 1:1188 BISHOP ST STE 3512
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3314
Mailing Address - Country:US
Mailing Address - Phone:808-550-0991
Mailing Address - Fax:808-550-0992
Practice Address - Street 1:1188 BISHOP ST STE 3512
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3314
Practice Address - Country:US
Practice Address - Phone:808-550-0991
Practice Address - Fax:808-550-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH0000TCCCNMedicare PIN