Provider Demographics
NPI:1851780282
Name:HUYNH, KELSEY KIMIYO (MFT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:KIMIYO
Last Name:HUYNH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:KIMIYO
Other - Last Name:TSUNEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:615 PIIKOI ST STE 203
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3139
Mailing Address - Country:US
Mailing Address - Phone:808-738-6819
Mailing Address - Fax:808-680-9108
Practice Address - Street 1:615 PIIKOI ST STE 203
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3139
Practice Address - Country:US
Practice Address - Phone:808-738-6819
Practice Address - Fax:808-680-9108
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT-434106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist