Provider Demographics
NPI:1811564800
Name:HAWAII NEUROPSYCHOLOGY LLC
Entity Type:Organization
Organization Name:HAWAII NEUROPSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-670-8668
Mailing Address - Street 1:1905 PIIMAUNA PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2615
Mailing Address - Country:US
Mailing Address - Phone:808-670-8668
Mailing Address - Fax:
Practice Address - Street 1:1003 BISHOP ST STE 2700
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-6475
Practice Address - Country:US
Practice Address - Phone:808-670-8668
Practice Address - Fax:808-207-6841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty