Provider Demographics
NPI:1588608277
Name:LABASAN, LYNETTE (PHD)
Entity Type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:LABASAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:L. MAILE
Other - Middle Name:
Other - Last Name:LABASAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1600 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 1306
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3801
Mailing Address - Country:US
Mailing Address - Phone:808-949-7444
Mailing Address - Fax:808-949-6262
Practice Address - Street 1:1600 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 1306
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3801
Practice Address - Country:US
Practice Address - Phone:808-949-7444
Practice Address - Fax:808-949-6262
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY759103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical