Provider Demographics
NPI:1992208086
Name:AMY WASSMAN PSYD LLC
Entity Type:Organization
Organization Name:AMY WASSMAN PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:KG
Authorized Official - Last Name:WASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-726-0750
Mailing Address - Street 1:1001 BISHOP ST STE 2870
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3482
Mailing Address - Country:US
Mailing Address - Phone:808-726-0750
Mailing Address - Fax:707-948-6036
Practice Address - Street 1:1001 BISHOP ST STE 2870
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3482
Practice Address - Country:US
Practice Address - Phone:808-726-0750
Practice Address - Fax:707-948-6036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-1240103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty