Provider Demographics
NPI:1720535776
Name:IAO MIND & BODY HEALTH, LLC
Entity Type:Organization
Organization Name:IAO MIND & BODY HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAUNANI
Authorized Official - Middle Name:
Authorized Official - Last Name:IAO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-389-2611
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty