Provider Demographics
NPI:1437472933
Name:WILSON, CYMA B (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CYMA
Middle Name:B
Last Name:WILSON
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 62055
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96839-2055
Mailing Address - Country:US
Mailing Address - Phone:808-256-6518
Mailing Address - Fax:888-528-0731
Practice Address - Street 1:3660 WAIALAE AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3257
Practice Address - Country:US
Practice Address - Phone:808-256-6518
Practice Address - Fax:888-528-0731
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 1087103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical