Provider Demographics
NPI:1639323918
Name:TRAMMEL, RICKY LOUIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICKY
Middle Name:LOUIS
Last Name:TRAMMEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:RICK
Other - Middle Name:LOUIS
Other - Last Name:TRAMMEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:6600 KALANIANAOLE HWY STE 225
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1281
Mailing Address - Country:US
Mailing Address - Phone:808-394-2800
Mailing Address - Fax:808-394-2826
Practice Address - Street 1:6600 KALANIANAOLE HWY STE 225
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1281
Practice Address - Country:US
Practice Address - Phone:808-394-2800
Practice Address - Fax:808-394-2826
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 1079103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist