Provider Demographics
NPI:1679748388
Name:SWENSON, GIULIETTA C (PSYD)
Entity Type:Individual
Prefix:
First Name:GIULIETTA
Middle Name:C
Last Name:SWENSON
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 1:270 WAIEHU BEACH RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1472
Mailing Address - Country:US
Mailing Address - Phone:808-244-1003
Mailing Address - Fax:
Practice Address - Street 1:270 WAIEHU BEACH RD
Practice Address - Street 2:SUITE 215
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1472
Practice Address - Country:US
Practice Address - Phone:808-244-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1028103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical