Provider Demographics
NPI:1134384738
Name:TANOUYE, ALLYSON M (PHD)
Entity type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:M
Last Name:TANOUYE
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 1:2640 DOLE STREET
Mailing Address - Street 2:E251
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2640 DOLE STREET
Practice Address - Street 2:E251
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822
Practice Address - Country:US
Practice Address - Phone:808-754-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY505103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist