Provider Demographics
NPI:1659560753
Name:IAO, HAUNANI M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HAUNANI
Middle Name:M
Last Name:IAO
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 722
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790-0722
Mailing Address - Country:US
Mailing Address - Phone:808-389-2611
Mailing Address - Fax:
Practice Address - Street 1:664 LAUIE DR
Practice Address - Street 2:
Practice Address - City:KULA
Practice Address - State:HI
Practice Address - Zip Code:96790-7218
Practice Address - Country:US
Practice Address - Phone:808-389-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 1210103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical