Provider Demographics
NPI:1710066113
Name:STRAUSS, MARILYN D (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:D
Last Name:STRAUSS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 BISHOP ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4817
Mailing Address - Country:US
Mailing Address - Phone:808-537-2869
Mailing Address - Fax:808-683-0783
Practice Address - Street 1:735 BISHOP ST
Practice Address - Street 2:SUITE 302
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4817
Practice Address - Country:US
Practice Address - Phone:808-537-2869
Practice Address - Fax:808-683-0783
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-336103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI2835-7OtherHMSA
HI02547501Medicaid
0000TCBRGMedicare ID - Type Unspecified
HI02547501Medicaid