Provider Demographics
NPI:1356796528
Name:ADRIANNA FLAVIN PHD LLC
Entity type:Organization
Organization Name:ADRIANNA FLAVIN PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FLAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-446-5545
Mailing Address - Street 1:69 ULUNUI PL
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8523
Mailing Address - Country:US
Mailing Address - Phone:808-446-5545
Mailing Address - Fax:
Practice Address - Street 1:7 AEWA PL
Practice Address - Street 2:UNIT 7
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8882
Practice Address - Country:US
Practice Address - Phone:808-446-5545
Practice Address - Fax:808-442-1058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY1449103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty