Provider Demographics
NPI:1750815114
Name:WALTER, ALEX BLISS (PHD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:BLISS
Last Name:WALTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1221 KAPIOLANI BLVD PH 50
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3518
Mailing Address - Country:US
Mailing Address - Phone:808-840-0787
Mailing Address - Fax:808-748-0433
Practice Address - Street 1:1221 KAPIOLANI BLVD, PENTHOUSE 38
Practice Address - Street 2:HAWAII PSYCHOLOGY COLLECTIVE
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-489-5919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI704103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical