Provider Demographics
NPI:1689118226
Name:FINK, LACEY (PSYD)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:FINK
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 1:438 HOBRON LN
Mailing Address - Street 2:STE 315
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1229
Mailing Address - Country:US
Mailing Address - Phone:808-554-9566
Mailing Address - Fax:
Practice Address - Street 1:438 HOBRON LN
Practice Address - Street 2:SUITE 315
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1233
Practice Address - Country:US
Practice Address - Phone:808-554-9566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-16
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1633103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical