Provider Demographics
NPI:1689169674
Name:LAWSON, MEI-LIN BRIDGET
Entity Type:Individual
Prefix:
First Name:MEI-LIN
Middle Name:BRIDGET
Last Name:LAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 KANOELEHUA AVE STE A204
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4670
Mailing Address - Country:US
Mailing Address - Phone:808-765-7722
Mailing Address - Fax:
Practice Address - Street 1:88 KANOELEHUA AVE STE A204
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4670
Practice Address - Country:US
Practice Address - Phone:808-933-0610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1887103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent