Provider Demographics
NPI:1205593720
Name:STUEBER, KYLA L (PSYD)
Entity type:Individual
Prefix:DR
First Name:KYLA
Middle Name:L
Last Name:STUEBER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-0133
Mailing Address - Country:US
Mailing Address - Phone:808-782-0844
Mailing Address - Fax:
Practice Address - Street 1:56-117 PUALALEA ST
Practice Address - Street 2:
Practice Address - City:KAHUKU
Practice Address - State:HI
Practice Address - Zip Code:96731-2052
Practice Address - Country:US
Practice Address - Phone:808-293-9221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-1956103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical