Provider Demographics
NPI:1629151451
Name:KAPANSKY WRIGHT, BETHANNE (PSYD)
Entity Type:Individual
Prefix:
First Name:BETHANNE
Middle Name:
Last Name:KAPANSKY WRIGHT
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 1216
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754-1216
Mailing Address - Country:US
Mailing Address - Phone:808-346-1674
Mailing Address - Fax:
Practice Address - Street 1:2538 TITCOMB ST
Practice Address - Street 2:
Practice Address - City:KILAUEA
Practice Address - State:HI
Practice Address - Zip Code:96754-5226
Practice Address - Country:US
Practice Address - Phone:808-346-1674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1724103TC0700X
AK556103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1724OtherPSYCHOLOGIST LICENSE #
AK556OtherPSYCHOLOGIST LICENSE #